Journal ArticleDOI
Anaphylaxis during anesthesia in France: An 8-year national survey
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TLDR
The incidence of allergic reactions during anesthesia, estimated on a national basis, is higher than previously estimated and the similar incidence of reactions according to sex before adolescence suggests a role for sex hormones in the increase of anaphylaxis observed in women.Abstract:
Background More attention should be paid to rare serious adverse events such as anaphylaxis to increase the safety of anesthesia. Objective To report the results of an 8-year survey of anaphylaxis during anesthesia in France. Methods Data from patients who experienced anaphylaxis between January 1, 1997, and December 31, 2004, were analyzed. Estimated incidences were obtained by combining this database with data from the French pharmacovigilance system by using a capture-recapture method. The number of patients exposed to the offending agents was obtained from data collected during the national survey of anesthesia practice. Results A total of 2516 patients was included. A diagnosis of IgE-mediated reaction was established in 1816 cases (72.18%). The most common causes were neuromuscular blocking agents ([NMBAs]; n = 1067; 58.08%), latex (n = 361; 19.65%), and antibiotics (n = 236; 12.85%). The median annual incidence per million procedures was higher for females 154.9 (5th-95th percentile, 117.2-193.1) than for males 55.4 (5th-95th percentile, 42.0-68.0). It reached 250.9 (5th-95th percentile, 189.8-312.9) for women in cases of allergic reactions to NMBAs. In children, a diagnosis of IgE-mediated reactions was obtained in 122 cases (45.9%). The most common causes were latex (n = 51; 41.8%), NMBAs (n = 39; 31.97%), and antibiotics (n = 11; 9.02%). In contrast with adults, no female predominance was observed. Conclusion The incidence of allergic reactions during anesthesia, estimated on a national basis, is higher than previously estimated. These results should be taken into account in the evaluation of the benefit-to-risk ratio of the various anesthetic techniques in individuals. The similar incidence of reactions according to sex before adolescence suggests a role for sex hormones in the increase of anaphylaxis observed in women.read more
Citations
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Epinephrine Self-Administration in Anaphylactic Emergencies Comparison of Commonly Available Autoinjectors
Felix S F Ram,Felix S F Ram,Felix S F Ram,Karen Hoare,Karen Hoare,Karen Hoare,Bruce Arroll,Bruce Arroll,Bruce Arroll,S Hoare,S Hoare,S Hoare +11 more
TL;DR: It is shown that on average, on device activation, syringe-based autoinjectors (eg, Anapen, Twinject, and Adrenaclick) are only capable of delivering 25.7% of the total amount of adrenaline during an anaphylactic emergency.
Journal ArticleDOI
Pholcodine exposure increases the risk of perioperative anaphylaxis to neuromuscular blocking agents: the ALPHO case-control study.
Paul-Michel Mertes,Nadine Petitpain,Charles Tacquard,M. Delpuech,Cédric Baumann,Jean-Marc Malinovsky,Dan Longrois,Aurélie Gouel-Chéron,Diane Le Quang,Pascal Demoly,Jean-Louis Guéant,Pierre Gillet,Emmanuelle Aguinet,Pol-André Apoil,J. E. Autegarden,Faiza Bettayeb,Celine Biermann,Maryline Bordes-Demolis,Anca-Mirela Chiriac,Pierre Antoine Darene,Frederic Deblay,Sabrina Dessard,C. Dzviga,H El Hanache,Alain Facon,Yannick Fuhrer,Noémie Gest,Marion Gouitaa,Adela Harpan,Cyrille Hoarau,L. Le Guillou,Laurence Lepeltier,C. Mailhol,Delphine Mariotte,Y. Meunier,I. Migueres,Martine Morisset,Catherine Neukirch,D. Nouar,Yann Ollivier,Isabelle Orsel,Omar Outtas,Minaxi L. Patel,Christelle Pellerin,Isabelle Petit,A. Pipet,Cécile Rochefort-Morel,J Schwartz,S Seltzer,Alice Seringulian,Angèle Soria,Lilia Soufir,Rodolphe Stenger,Céline Tummino,Marion Verdaguer +54 more
TL;DR: In this paper , a multicentre case-control study was conducted to assess the relationship between pholcodine exposure and NMBA-related perioperative anaphylaxis, and most of these reactions are IgE mediated.
Anafilaxia induzida por fármacos: Registo Nacional 2007-2010 Drug-induced anaphylaxis: National Survey 2007-2010
Emília Faria,Josefina Rodrigues-Cernadas,Ângela Gaspar,Carmen Botelho,Eunice Dias de Castro,Anabela Lopes,Eva Rebelo Gomes,Daniela Malheiro,Susana Cadinha,Sofia Campina-Costa,Marta Neto,Nuno Sousa,Rodrigo Rodrigues-Alves,AM Romeira,Joana Caiado,Mário Morais-Almeida,Grupo de Interesse +16 more
TL;DR: The main culprit drugs were the non -steroidal anti -inflammatory drugs (NSAIDs), antibiotics and anesthetic agents in 48%, 36% and 6% of the cases respectively, and they were associated with a higher rate of recurrence of anaphylaxis.
Guideline for the diagnosis of drug hypersensitivity reactions: S2K-Guideline of the German Society for Allergology and Clinical Immunology (DGAKI) and the German Dermatological Society (DDG) in collaboration with the Association of German Allergologists
Knut Brockow,Bernhard Przybilla,Werner Aberer,Andreas J. Bircher,Randolf Brehler,Heinrich Dickel,Thomas Fuchs,Thilo Jakob,Lars Lange,Wolfgang Pfützner,Maja Mockenhaupt,Hagen Ott,Oliver Pfaar,Johannes Ring,Bernhardt Sachs,H. Sitter,Axel Trautmann,Regina Treudler,Bettina Wedi,Margitta Worm,Gerda Wurpts,Torsten Zuberbier,Hans F. Merk +22 more
TL;DR: In this article, the key principles of diagnosing allergic/hypersensitivity drug reactions are presented, where possible, the objective is to perform allergy diagnostics within 4 weeks-6 months following the reaction.
Journal ArticleDOI
Abordagem das reações de hipersensibilidade perioperatória: Orientações da Sociedade Brasileira de Anestesiologia e da Associação Brasileira de Alergia e Imunologia - Parte II: etiologia e diagnóstico
Dirceu Solé,Maria Anita Costa Spindola,Marcelo Vivolo Aun,Liana Maria Tôrres de Araújo Azi,Luiz Antonio Guerra Bernd,Daniela Bianchi,Albertina Varandas Capelo,Débora de Oliveira Cumino,Alex Eustáquio de Lacerda,Luciana Cavalcanti Lima,Edelton Flávio Morato,Rogean Rodrigues Nunes,Norma de Paula Motta Rubini,Jane da Silva,Maria Angela Tardelli,Alexandra Sayuri Watanabe,Erick Freitas Curi,Flávio Sano +17 more
TL;DR: Neste documento são revisados os mecanismos fisiopatológicos, agentes desencadeantes (adultos e crianças), assim como a abordagem diagnóstica durante a crise e após o episódio, sobre a anafilaxia perioperatória.
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