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Perioperative anaphylaxis

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https://www.readbyqxmd.com/read/28984794/the-use-of-povidone-iodine-in-ophthalmology
#1
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...
October 3, 2017: Current Opinion in Ophthalmology
https://www.readbyqxmd.com/read/28937421/methylene-blue-to-treat-refractory-latex-induced-anaphylactic-shock-a-case-report
#2
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
#3
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
#4
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
#5
Richard L Baretto, Sarah Beck, Jane Heslegrave, Cathryn Melchior, Omar Mohamed, Anjali Ekbote, Aarnoud P Huissoon, Mamidipudi T Krishna
INTRODUCTION: There is no standardised method for assessing serum total mast cell tryptase (MCT) in anaphylaxis. The consensus equation (peak MCT should be>1.2x baseline tryptase+2mg/L) has been proposed to interpret acute MCT in mast cell activation syndrome (MCAS). AIM: To validate consensus equation in a setting of perioperative anaphylaxis. METHODS: Analyses of suspected perioperative anaphylaxis during general anaesthesia (GA). Anaphylaxis was defined as per World Allergy Organisation (WAO) criteria...
June 13, 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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/28267935/perioperative-anaphylaxis-progress-prevention-and-pholcodine-policy
#13
EDITORIAL
P T McAleer, L McNicol, M A Rose
No abstract text is available yet for this article.
March 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28164272/anaphylaxis-during-general-anaesthesia-experience-from-a-drug-allergy-centre-in-the-uk
#14
J Meng, G Rotiroti, E Burdett, J J Lukawska
BACKGROUND: Anaphylaxis during general anaesthesia is rare but often severe. Identification of the cause of anaphylaxis and recommendation of a range of drugs or agents likely to be safer for future surgery is a collaborative venture between the allergists and the anaesthesiologists, but it often poses a significant challenge. METHODS: A total of 31 patients who attended the Drug Allergy Unit at University College London Hospital with suspected perioperative anaphylaxis between March 2013 and January 2016 were reviewed retrospectively...
March 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28118212/delayed-anaphylaxis-to-mammalian-meat-following-tick-exposure-and-its-impact-on-anesthetic-management-for-cardiac-surgery-a-case-report
#15
Amanda M Kleiman, Keith E Littlewood, Danja S Groves
Hypersensitivity reactions to mammalian meat following tick exposure are increasing in prevalence and provide a unique challenge to anesthesiologists. The reactions, including anaphylaxis, are delayed and therefore may not be easily recognized and treated. The risk is especially high in cardiac surgery, where several potential triggers, including biological valves as well as heparin, are used frequently. In the presence of such hypersensitivity, prophylactic measures including preoperative testing and pharmacologic prophylaxis may be useful in modulating the immune response such that triggering agents may be used relatively safely...
April 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28077533/cefalotin-as-antimicrobial-prophylaxis-in-patients-with-known-intraoperative-anaphylaxis-to-cefazolin
#16
P H M Sadleir, R C Clarke, P R Platt
BACKGROUND: The most common trigger for intraoperative anaphylaxis in Western Australia for the period 2014-5 was an antibiotic used for surgical prophylaxis, cefazolin. In these patients who subsequently present for surgery, alternative cephalosporins are forbidden by current guidelines because of concerns regarding an increased risk of anaphylaxis. However, consideration of the structure-activity relationships relevant to anaphylaxis suggests that cefalotin is a safe alternative because of structural dissimilarities, although there are no pubished clinical data relevant to the perioperative setting...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27871567/intraoperative-medications-associated-with-hemodynamically-significant-anaphylaxis
#17
Robert E Freundlich, Neal M Duggal, Michelle Housey, Tyler T Tremper, Milo C Engoren, Sachin Kheterpal
STUDY OBJECTIVE: To facilitate the identification of drugs and patient factors associated with hemodynamically significant anaphylaxis. DESIGN: Using an existing database containing complete perioperative records, instances of hemodynamically significant anaphylaxis were identified using a physiologic and treatment-based screening algorithm. All cases were manually reviewed by 2 clinicians, with a third adjudicating disagreements, and confirmed cases were matched 3:1 with control cases...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27853881/a-suspected-case-of-rocuronium-sugammadex-complex-induced-anaphylactic-shock-after-cesarean-section
#18
Masakazu Yamaoka, Miki Deguchi, Kiichiro Ninomiya, Toshiaki Kurasako, Mutsuko Matsumoto
An anaphylactic reaction during a cesarean section occurs rarely, and rocuronium is thought to be one of the common agents causing perioperative anaphylaxis. Here we report an anaphylactic shock after cesarean section that is suggested to be induced by the rocuronium-sugammadex complex. A 36-year-old primigravida underwent an elective cesarean section under general anesthesia due to placenta previa. While the operation was completed uneventfully, she developed anaphylactic shock following sugammadex administration...
February 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/27822310/anaphylactic-shock-during-cement-implantation-of-a-total-hip-arthroplasty-in-a-patient-with-underlying-mastocytosis-case-report-of-a-rare-intraoperative-complication
#19
Anita Ten Hagen, Pieter Doldersum, Tom van Raaij
BACKGROUND: Cemented total hip arthroplasty (THA) is a safe and common procedure. In rare cases life threatening bone cement implantation syndrome (BCIS) may occur, which is commonly caused by pulmonary embolism (PE). CASE PRESENTATION: We describe the rare case of a 70-year old patient who underwent an elective total hip replacement. Before surgery he was diagnosed with underlying systemic indolent mastocytosis, a rare pathological disorder that may result in anaphylaxis after massive systemic mast cell activation...
2016: Patient Safety in Surgery
https://www.readbyqxmd.com/read/27772805/a-novel-diagnostic-approach-in-a-case-of-perioperative-anaphylaxis-utilising-basophil-activation-testing-and-specific-ige-sige-inhibition-studies
#20
Fenfen Cai, Janet Anderson, Michael Rose, Sarah Green, Lyndsay Peters, Jamma Li, Richard B Fulton, Suran L Fernando
No abstract text is available yet for this article.
February 2016: Pathology
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