Anaphylaxis after induction to general anaesthesia: Four case reports

Czech version

Authors: Frančáková Jana; Fiala Hynek
Authors‘ workplace: Klinika anesteziologie a resuscitace Fakultní nemocnice Olomouc
Published in: Anest. intenziv. Med., 20, 2009, č. 2, s. 73-77
Category: Anaesthesiology - Case Report

Overview

Allergic reactions during regional and general anaesthesia represent relatively infrequent but serious complications. Out of the drugs used in anaesthetics, the most common triggers of allergic reactions are muscle relaxants, particularly suxamethonium and rocuronium. Atracurium on the other hand usually causes anaphylactoid reactions. The authors present four case reports illustrating the anaphylactic and anaphylactiod reactions. The pathophysiology, diagnostics and management of serious allergic reactions are discussed. The authors also discuss the preoperative assesment and preparation of allergic patients and the preparation of the anaesthesiologists for managing these complications.

Keywords:
anaphylaxis – muscle relaxants – rocuronium – anaesthesia

Sources

1. Adamus, M., Koutná, J., Neoral, Č. Výskyt pooperační reziduální kurarizace na dospávacím pokoji po aplikaci rokuronia. Rozhl. Chir., 2007, 86, s. 11–16.

2. Adamus, M. Monitorování nervosvalového přenosu v anesteziologii. 1. vyd. Olomouc: Vydavatelství Univerzity Palackého v Olomouci, 2007, 84 s. ISBN 978-80-244-1718-9.

3. Mertes, P. M., Laxenaire, M. C. Anaphylactic and Anaphylactoid Reactions Occurring During Anaesthesia in France. Seventh epidemiologic survey (January 2001-December 2002). Ann. Fr. Anesth. Reanim., 2004, 23, p. 1133–1143.

4. Harboe, T., Guttormsen, A. B., Irgens, A., Dybendal, T., Florvaag, E. Anaphylaxis During Anesthesia in Norway: a 6-year single-center follow-up study. Anesthesiology, 2005, 102, p. 897–903.

5. Fischer, M. M., Baldo B. A. The Incidence and Clinical Features of Anaphylactic Reactions During Anesthesia in Australia. Ann. Fr. Anesth. Reanim., 1993, 12, p. 97–104.

6. Herold, I. Svalová relaxancia v anesteziologii a intenzivní péči. 1. vyd. Praha: Maxdorf Jessenius, 2004, s. 178–182. ISBN 80-7345-025-9.

7. Petrů, V., Krčmová, I. Anafylaktická reakce. 1. vyd. Praha: Maxdorf Jessenius, 2006, 112 s. ISBN 80-7345-099-2.

8. Caughey, G. H. Tryptase Genetics and Anaphylaxis. J. Allergy Clin. Immunol., 2006, 117, p. 1411–1414.

9. Brown, S. G., Blackman, K. E., Stenlake, V., Heddle, R. J. Insect Sting Anaphylaxis; Prospective Evaluation of Treatment with Intravenous Adrenaline and Volume Resuscitation. Emerg. Med. J., 2004, 21, p. 149–154.

10. Bonifazi, F., Jutel, M., Bilò, B. M., Birnbaum, J., Muller, U. Prevention and Treatment of Hymenoptera Venom Allergy: Guidelines for Clinical Practice. Allergy, 2005, 60, p. 1459–1470. Dostupný také na: www.eaaci.net/media/PDF/P/653.pdf.

Labels

Anaesthesiology, Resuscitation and Inten Intensive Care Medicine

Anterior spinal artery syndrome as a complication of neuroaxial blocade – successful treatment with prostacyclin (case report)

Erythropoietin and other erythropoiesis-stimulating drugs and bloodless medicine – a new era in the management of anaemia?

The influence of continuous positive pressure ventilation on the degree of inflammatory reaction and organ function – experimental study

Hypocholesterolaemia on the medical intensive care unit: The process of cholesterol synthesis and absorption is altered in the acute phase of disease

Evaluation of changes in brain tissue oxygen levels (PbtO2) for detection of vasospasm in patients after subarachnoid haemorrhage

A fatal complication of tracheostomy in a 13-year-old patient with Duchenne Muscular Dystrophy – case report

Assoc. Prof. MUDr. Josef Hoder, CSc., in the memories of his colleagues and friends

Assoc. Prof. MUDr Josef Hoder, CSc. (1912–1987)

Article was published in

Anaesthesiology and Intensive Care Medicine

2009 Issue 2