The authors present a case of a patient with multiple episodes of perioperative anaphylaxis. The incidence and the most common causes of perioperative anaphylaxis are reviewed. The most common causes can vary by country and the type of perioperative medications used. The unique environment and the multiple medications and substances used in the anesthesia and surgical setting that make a definitive diagnosis challenging are outlined. A systematic strategy to recognize the reaction, identify the culprit, and direct future management are demonstrated. Management of the patient experiencing perioperative anaphylaxis requires close collaboration between the anesthesia, surgical, and allergy teams.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.jaip.2019.05.033 | DOI Listing |
J Allergy Clin Immunol Glob
February 2025
Division of Allergy, Asthma and Clinical Immunology, Mayo Clinic, Scottsdale, Ariz.
Background: Chlorhexidine gluconate (CHX), a common cause of perioperative anaphylaxis, is frequently used for skin testing in allergy evaluations. Although CHX's maximal nonirritating concentrations are known, the stability of its dilutions for skin testing remains unexplored, particularly when sterile water for injection (SWFI) or normal saline (NS) are used as diluents.
Objective: Our aim was to evaluate the stability and precipitation of CHX when diluted with SWFI or NS for drug allergy skin testing.
Br J Anaesth
January 2025
Department of Theatres and Anaesthesia, St James' University Hospital, Leeds, UK.
Neuromuscular blocking agents are a common cause of perioperative hypersensitivity. The sensitivity and specificity of skin tests and in vitro tests in this context have not been determined conclusively, which poses a barrier to accurate diagnosis. Use of challenge testing represents a promising development in this field and a key tool in confirming tolerance to an alternate neuromuscular blocking agent for use in future anaesthesia.
View Article and Find Full Text PDFAllergy Asthma Proc
January 2025
Perioperative anaphylaxis is a serious entity with high morbidity and mortality. Perioperative anaphylaxis can be caused by any of the multitude of medications and substances used in anesthesia and surgery, and the most common causes include neuromuscular blocking agents, antibiotics, antiseptics, latex, and dyes. The differential diagnosis of perioperative anaphylaxis is wide from both an immunologic and a nonimmunologic standpoint.
View Article and Find Full Text PDFJ Vasc Access
December 2024
Department of Catheter Clinic, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, P.R. China.
J Allergy Clin Immunol Glob
February 2025
Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tenn.
Background: Since the publication of the 2022 Drug Allergy Practice Parameters (DAPP) of the American Academy of Allergy, Asthma & Immunology (AAAAI) and American College of Allergy, Asthma & Immunology (ACAAI), it is unclear the extent to which the simplified and risk-stratified evaluation of cephalosporin allergy has been incorporated into allergy practice.
Objective: We aimed to assess current cephalosporin allergy testing practices using real case examples.
Methods: An 18-question REDCap survey was sent to the 136 members of the Adverse Reactions to Drugs, Biologics and Latex (ARDBL) Committee of the AAAAI between February and April 2023.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!