The allergologic survey of the patient at risk of perioperative anaphylaxis

Nadia Gherman-Ionică, Ramona Bologa, Cristina Indrei, Denisa Hagău, D. Dîrzu, S. Trancă, Natalia Hagău

Compartimentul de Alergoanestezie, Catedra ATI II
Universitatea de Medicină şi Farmacie „Iuliu Haţieganu” Cluj-Napoca

Abstract

The allergologic survey of the patient at risk of developing perioperative anaphylactic reaction is an important step in establishing this diagnosis and is part of the medical strategy of reducing this risk for the surgical patient. The allergoanesthesic team, which includes anesthesia and intensive care professionals, allergologists trained in alergoanesthesia and experienced immunologists trained in the realisation and interpretation of the radioimmunoassay and of the basophil activation tests, establishes the drug hypersensitivity diagnosis. The allergologic survey identifies through specific allergologic tests the substances responsible for the perianesthetic anaphylactic reactions and has the role to offer safe alternative substances for subsequent surgical interventions. These tests are performed by an allergologist and include prick tests and intradermic tests and are strengthened by the results of the in vitro tests (including the specific IgE antibodies and basophil activation test). The anaesthesiologist is informed upon the results of the tests, being able to choose the appropriate anesthetic technique with the minimum risk for the patient. Identifying anphylaxis risk factors by the anaesthesiologist during the preanesthetic evaluation leads to the necessity to perform allergologic investigations as well as in vitro tests at the Allergoanesthesia Department.

Keywords: allergoanesthesia, cutaneous prick and intradermic tests, IgE specific, bazophil activation tes