2. Perianaesthetic anaphylaxis. Initial results of the first Romanian allergo-anaesthesia center

Nadia Gherman-Ionica ¹, Erika Susana Brezoszki², Manuela Sfichi³, Ramona Bologa¹, Natalia Hagau

1 University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Allergology Department
2 University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, Anaesthesiology Department
3 Emergency Clinical County Hospital Cluj-Napoca, Immunology Laboratory

Abstract

Background. There are differences between the results of studies performed in different centres, regarding the substances responsible for anaesthetic related anaphylaxis, although the NMBAs were identified as the most common agents.

Methods. For 2½ years (January, 2008-June, 2010) the patients presenting with perianaesthetic anaphylaxis were analyzed in the Anaesthetic Allergy Centre within the Cluj University. The diagnosis was based on case history, skin prick and intradermal tests, specific IgE measurement and was enforced by BAT. Reactions were defined as IgE-mediated (anaphylactic-type), if positive skin tests, and/or specific IgEs occur.

Results. 22 patients, 13 females, 9 males, ages ranging between 4 and 67 were studied. An IgE mediated mechanism was confirmed in 18/22 patients (82%). The etiological agents were the NMBAs in 9 cases (50%), hypnotics in 3 cases (17%), latex and antibiotics, 2 cases each (11%), and one case each for lidocaine and neostigmine (6%).

Conclusions. In the majority of the cases an IgE mediated mechanism was identified. The most frequent substances responsible for allergic reactions were the NMBAs, followed by hypnotics, latex, antibiotics and other substances, as it resulted form skin tests, and specific IgE measurements.

Keywords: anaesthesia, anaphylaxis, hypersensitivity, perianaesthetic reactions

J Rom Anest Terap Int 2011; 18: 87-94

Reacţiile anafilactice perianestezice. Rezultatele iniţiale ale primului centru român de alergoanestezie