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Perioperative anaphylaxis

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https://www.readbyqxmd.com/read/29684989/intradermal-skin-tests-for-rocuronium-and-cisatracurium-in-patients-with-a-history-of-allergy-a-retrospective-study
#1
Yu Yil Kim, Ik Thae Kim, Sung In Shin, So Mang Yim
Background: Neuromuscular blocking agents (NMBAs) are a leading cause of perioperative anaphylaxis. However, the performance of systematic screening skin tests to detect reactions for NMBAs prior to general anesthesia is not recommended. We retrospectively examined intradermal tests (IDTs) for rocuronium and cisatracurium in patients with a history of allergy. Methods: We reviewed the records of patients who underwent IDTs for NMBAs between January 1 and December 31, 2016...
April 24, 2018: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29501378/is-surgical-antibiotic-prophylaxis-necessary-for-pediatric-orchiopexy
#2
A J Rensing, B M Whittam, K H Chan, M P Cain, A E Carroll, W E Bennett
INTRODUCTION: Surgeons frequently use surgical antibiotic prophylaxis (SAP), despite limited evidence to support its efficacy. Potential adverse events associated with antibiotic use include allergic reaction (including anaphylaxis), Clostridium difficile infection, and selecting for resistant bacteria. Surgical site infections (SSI) are very rare in patients undergoing clean pediatric urologic procedures. Current guidelines are unclear about the efficacy of surgical antibiotic prophylaxis for prevention of SSI in the pediatric population...
February 21, 2018: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29483746/-prevalance-of-peri-anesthesia-allergy-and-its-related-risk-factor-a-retrospective-survey-from-2012-2017
#3
B J Wang, C Guo, C J Li, D L Mu
OBJECTIVE: To investigate the incidence of peri-anesthesia allergy in a tertiary teaching hospital. METHODS: This was a retrospective cohort study. Patients who received anesthesia in operation rooms at Peking University First Hospital from January 2012 to April 2017 were enrolled. Researchers reviewed all the patients' electronic records and screened suspect allergy cases. Allergy was diagnosed according to the definition in Consensus on Management of Perioperative Allergy (China) and Scandinavian Clinical Practice Guidelines on the Diagnosis, Management and Follow-up of Anaphylaxis during Anesthesia...
February 18, 2018: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/29461315/perioperative-cardiac-arrest-focus-on-anaphylaxis
#4
(no author information available yet)
No abstract text is available yet for this article.
March 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29368335/morphine-and-pholcodine-specific-ige-have-limited-utility-in-the-diagnosis-of-anaphylaxis-to-benzylisoquinolines
#5
M A Rose, J Anderson, S L Green, J Yun, S L Fernando
BACKGROUND: Investigation of immediate hypersensitivity reactions in the perioperative setting involves skin testing and measurement of specific IgE (sIgE) as standard practice. In the case of the neuromuscular blocking agents (NMBAs), the main allergenic epitopes have been shown to be substituted ammonium groups. Commercial assays are available for detection of sIgE to these epitopes using morphine and pholcodine substrates but questions have been raised about the effectiveness of these assays in the diagnosis of benzylisoquinoline anaphylaxis...
January 24, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29176374/intraoperative-vasoplegia-methylene-blue-to-the-rescue
#6
Sharon L McCartney, Lorent Duce, Kamrouz Ghadimi
PURPOSE OF REVIEW: To evaluate the efficacy, dosing, and safety of methylene blue (MTB) in perioperative vasoplegic syndrome (VS). RECENT FINDINGS: Vasoplegic syndrome is a state of persistent hypotension with elevated cardiac output, low filling pressures, and low systemic vascular resistance (SVR). It occurs in up to 25% of patients undergoing cardiac surgery with cardiopulmonary bypass, can last up to 72 h, and is associated with a high mortality rate. MTB has been found to increase SVR and decrease vasopressor requirements in vasoplegic syndrome by inhibiting nitric oxide synthase, thus limiting the generation of nitric oxide, while inhibiting activation of soluble guanylyl cyclase and preventing vasodilation...
February 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29109644/xylometazoline-nasal-drops-induced-anaphylaxis-an-atypical-perioperative-complication
#7
Rudrashish Haldar, Sukhminderjit Singh Bajwa, Jasleen Kaur
Xylometazoline nasal drops used for nasal decongestion can have side-effect in the form of palpitation, hypertension, headache, and tremors. Anaphylaxis to xylometazoline nasal drops is a relatively unrecognized complication. We encountered a patient posted for tonsillectomy who developed serious anaphylaxis upon administration of a commercially available preparation of xylometazoline nasal drops and required aggressive management for stabilization. Further evaluation and literature search indicated toward the preservative (benzylalkonium chloride) as the cause of this adverse event...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29090247/perioperative-red-blood-cell-transfusion-in-orofacial-surgery
#8
REVIEW
So-Young Park, Kwang-Suk Seo, Myong-Hwan Karm
In the field of orofacial surgery, a red blood cell transfusion (RBCT) is occasionally required during double jaw and oral cancer surgery. However, the question remains whether the effect of RBCT during the perioperative period is beneficial or harmful. The answer to this question remains challenging. In the field of orofacial surgery, transfusion is performed for the purpose of oxygen transfer to hypoxic tissues and plasma volume expansion when there is bleeding. However, there are various risks, such as infectious complications (viral and bacterial), transfusion-related acute lung injury, ABO and non-ABO associated hemolytic transfusion reactions, febrile non-hemolytic transfusion reactions, transfusion associated graft-versus-host disease, transfusion associated circulatory overload, and hypersensitivity transfusion reaction including anaphylaxis and transfusion-related immune-modulation...
September 2017: Journal of Dental Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28984794/the-use-of-povidone-iodine-in-ophthalmology
#9
REVIEW
Andrzej Grzybowski, Piotr Kanclerz, William G Myers
PURPOSE OF REVIEW: Povidone-iodine (PVI) is a disinfectant and antiseptic agent used for preoperative preparation of the skin and mucous membranes, as well as for the treatment of contaminated wounds. Currently regimens for prophylaxis against postsurgical endophthalmitis are being modified, including a total withdrawal of antibiotics in intravitreal injections. The aim of this study was to evaluate the use of PVI in ophthalmology. RECENT FINDINGS: As a result of its broad spectrum of microbicidal activity, PVI is routinely used in ophthalmic surgery...
January 2018: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28937421/methylene-blue-to-treat-refractory-latex-induced-anaphylactic-shock-a-case-report
#10
Paulo Sergio Da Silva, Paula Furtado
Anaphylaxis occurs in 1/5000-1/20,000 of anesthesia cases and may evolve with shock and cardiovascular collapse in up to 54% of cases. Mortality varies from 3% to 10%. Latex is the second leading cause of anaphylaxis during the perioperative period. We report a case of latex-induced anaphylactic shock refractory to the usual catecholamine treatment that was reversed with the aid of methylene blue. Exaggerated activation of the nitric oxide-cyclic guanosine monophosphate pathway is observed in refractory shock...
September 20, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28911283/australian-and-new-zealand-anaesthetic-allergy-group-perioperative-anaphylaxis-investigation-guidelines
#11
R J Scolaro, H M Crilly, E J Maycock, P T McAleer, K A Nicholls, M A Rose, Rih The
These guidelines are a consensus document developed by a working party of the Australian and New Zealand Anaesthetic Allergy Group (ANZAAG) to provide an approach to the investigation of perioperative anaphylaxis. They focus primarily on the use of skin testing as it is the investigation with the greatest clinical utility for the identification of the likely causative agent and potentially safer alternatives. The practicalities and process of skin testing, its limitations, and the place of other tests are discussed...
September 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28888257/gelatin-anaphylaxis-during-surgery-a-rare-cause-of-perioperative-anaphylaxis
#12
Rekha Raveendran, David A Khan
No abstract text is available yet for this article.
September 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28609557/validation-of-international-consensus-equation-for-acute-serum-total-tryptase-in-mast-cell-activation-a-perioperative-perspective
#13
R L Baretto, S Beck, J Heslegrave, C Melchior, O Mohamed, A Ekbote, A P Huissoon, M T Krishna
There is no standardized method for assessing serum total mast cell tryptase (MCT) in anaphylaxis. The consensus equation (peak MCT should be>1.2× baseline tryptase+2 mg/L) has been proposed to interpret acute MCT in mast cell activation syndrome (MCAS). To validate consensus equation in a perioperative setting analyses of cases of suspected perioperative anaphylaxis during general anaesthesia (GA) were performed. Anaphylaxis was defined as per World Allergy Organisation (WAO) criteria. Timed serial MCT measurements were mapped against the consensus equation and receiver operating characteristic (ROC) curves produced...
December 2017: Allergy
https://www.readbyqxmd.com/read/28590439/reclassifying-anaphylaxis-to-neuromuscular-blocking-agents-based-on-the-presumed-patho-mechanism-ige-mediated-pharmacological-adverse-reaction-or-innate-hypersensitivity
#14
REVIEW
David Spoerl, Haig Nigolian, Christoph Czarnetzki, Thomas Harr
Approximately 60% of perioperative anaphylactic reactions are thought to be immunoglobulin IgE mediated, whereas 40% are thought to be non-IgE mediated hypersensitivity reactions (both considered non-dose-related type B adverse drug reactions). In both cases, symptoms are elicited by mast cell degranulation. Also, pharmacological reactions to drugs (type A, dose-related) may sometimes mimic symptoms triggered by mast cell degranulation. In case of hypotension, bronchospasm, or urticarial rash due to mast cell degranulation, identification of the responsible mechanism is complicated...
June 7, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28498889/uk-anaesthetists-perspectives-and-experiences-of-severe-perioperative-anaphylaxis-nap6-baseline-survey
#15
H I Kemp, T M Cook, M Thomas, N J N Harper
Background: There is limited information on UK anaesthetists' perspectives and experiences of perioperative anaphylaxis. This baseline survey of the Sixth National Audit Project (NAP6) aimed to identify relevant departmental preparedness and practices, and individual experiences, perceptions and drug-avoidance patterns. Methods: All anaesthetists in 356 UK NHS hospitals were invited to complete an electronic survey. Results: 11 104 anaesthetists (77% crude response rate) from 341 (96%) hospitals responded...
July 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28492106/higher-risk-of-revision-for-infection-using-systemic-clindamycin-prophylaxis-than-with-cloxacillin
#16
Otto Robertsson, Olof Thompson, Annette W-Dahl, Martin Sundberg, Lars Lidgren, Anna Stefánsdóttir
Background and purpose - Clindamycin has not been compared with other antibiotics for prophylaxis in arthroplasty. Since 2009, the Swedish Knee Arthroplasty Register (SKAR) has been collecting information on the prophylactic antibiotic regime used at every individual operation. In Sweden, when there is allergy to penicillin, clindamycin has been the recommended alternative. We examined whether there were differences in the rate of revision due to infection depending on which antibiotic was used as systemic prophylaxis...
October 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28483312/current-knowledge-and-management-of-hypersensitivity-to-perioperative-drugs-and-radiocontrast-media
#17
Karen S Hsu Blatman, David L Hepner
Perioperative anaphylaxis is an iatrogenic clinical condition, most often after anesthetic induction. Several mechanisms are implicated, including IgE- and non-IgE-mediated mechanisms. Perioperative anaphylaxis tends to be severe and has a higher mortality rate than anaphylaxis in other settings. This is partly due to factors that impair early recognition of anaphylaxis. Neuromuscular blocking agents, latex containing products, and antibiotics are the most common etiology. Chlorhexidine and dyes are increasingly culprits...
May 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28409044/perioperative-anaphylaxis-to-chlorhexidine-during-surgery-and-septoplasty
#18
Ana Paula Teixeira de Abreu, Leonardo Ramos Ribeiro de Oliveira, Ana Flavia Teixeira de Abreu, Evandro Ribeiro de Oliveira, Michele Santos de Melo Ireno, Fernando Monteiro Aarestrup, Matheus Fonseca Aarestrup, Paula Fonseca Aarestrup
Chlorhexidine is an antiseptic and disinfectant used in surgical and clinical practice since 1954 and is available in aqueous or alcoholic solutions 0.5%-4.0% and has a broad-spectrum activity. Despite their widespread use, allergic reactions with chlorhexidine are rarely reported. We describe a case of anaphylaxis with chlorhexidine during a septoplasty, turbinectomy, and maxillary sinusectomy. The patient presented with periorbital edema, hives, hypotension, and wheezing. Immediately after the diagnosis of anaphylaxis promethazine, hydrocortisone, and epinephrine were administered with immediate clinical improvement...
2017: Case Reports in Otolaryngology
https://www.readbyqxmd.com/read/28294589/selective-hypersensitivity-to-cefazolin-and-contribution-of-the-basophil-activation-test
#19
J P Almeida, A Lopes, A Campos Melo, M C Pereira Santos, M Pereira Barbosa
The authors present 2 case reports of selective cefazolin hypersensitivity: a 49 year-old woman with a history of two perioperative reactions (urticaria and severe anaphylaxis) after the use of rocuronium, propophol and cefazolin; a 36 year-old pregnant woman who developed facial erythema, lips angioedema and hypotension immediately after administration of ropivacain, sufentanil, cefazolin, oxytocin and ephedrine. In both cases, intradermal skin tests were positive for cefazolin. A basophil activation test was performed for cefazolin, which was positive in one patient...
March 2017: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28267936/australian-and-new-zealand-anaesthetic-allergy-group-australian-and-new-zealand-college-of-anaesthetists-perioperative-anaphylaxis-management-guidelines
#20
H Kolawole, S D Marshall, H Crilly, R Kerridge, P Roessler
Anaphylaxis is an uncommon but important cause of serious morbidity and even mortality in the perioperative period. The Australian and New Zealand College of Anaesthetists (ANZCA) with the Australian and New Zealand Anaesthetic Allergy Group (ANZAAG) have developed clinical management guidelines that include six crisis management cards. The content of the guidelines and cards is based on published literature and other international guidelines for the management of anaesthesia-related and non-anaesthesia-related anaphylaxis...
March 2017: Anaesthesia and Intensive Care
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