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Allergy anesthesia

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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/29679123/-wide-awake-hand-surgery-based-on-application-examples
#2
P Kaiser, M Keller, J Dörler, G Schmidle
OBJECTIVE: Anesthesiologic method with low bleeding level, risk level, and complication rate for surgical procedures on the hand without a tourniquet on an unsedated patient with the possibility for functional testing during surgery. INDICATIONS: Surgical procedures of the hand can be carried out using the wide awake technique depending on the patient's suitability and preference considering individual risk factors. CONTRAINDICATIONS: Absolute contraindications are allergies to the local anesthetic or its components...
April 20, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29517573/usefulness-of-basophil-activation-tests-for-diagnosis-of-sugammadex-induced-anaphylaxis
#3
Tatsuo Horiuchi, Akihiko Yokohama, Masaki Orihara, Yukinari Tomita, Akihiro Tomioka, Nagahide Yoshida, Kenichiro Takahashi, Shigeru Saito, Tomonori Takazawa
BACKGROUND: Sugammadex is used to reverse the effects of neuromuscular blocking agents in many cases of general anesthesia. However, there are several reports of anaphylaxis after its use. Skin testing is the gold standard for detecting the causative agent of anaphylaxis. However, due to the lack of validated protocols for skin testing with sugammadex, the diagnostic accuracy might be inadequate. Recently, the basophil activation test (BAT) has been established as a tool to detect the causative agent of anaphylaxis with high sensitivity and specificity...
May 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29483746/-prevalance-of-peri-anesthesia-allergy-and-its-related-risk-factor-a-retrospective-survey-from-2012-2017
#4
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/29459111/a-trial-of-two-anesthetic-regimes-for-minimally-invasive-mitral-valve-repair
#5
Marco Moscarelli, Nora Terrasini, Anna Nunziata, Prakash Punjabi, Gianni Angelini, Marco Solinas, Alba Buselli, Paolo Del Sarto, Dorela Haxhiademi
OBJECTIVE: Minimally invasive mitral valve repair may be associated with prolonged cardioplegic arrest times and ischemic reperfusion injury. Intravenous (propofol) and volatile (sevoflurane) anesthesia are used routinely during cardiac surgery and are thought to provide cardioprotection; however, the individual contribution of each regimen to cardioprotection is unknown. Therefore, the authors sought to compare the cardioprotective effects of propofol and sevoflurane anesthesia in patients undergoing minimally invasive mitral valve repair...
January 31, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29454709/in-vitro-diagnosis-of-immediate-drug-hypersensitivity-during-anesthesia-a-review-of-the-literature
#6
Didier G Ebo, Margaretha Faber, Jessy Elst, Athina L Van Gasse, Chris H Bridts, Christel Mertens, Luc S De Clerck, Margo M Hagendorens, Vito Sabato
Quantification of specific IgE (sIgE) antibodies constitutes an important measure to document anesthesia-related immediate hypersensitivity reactions (IHRs). However, only a few drug-specific assays are available and their predictive value is not known. In cases of non-IgE mediated IHRs, diagnosis might benefit from cellular tests such as basophil mediator release tests and basophil activation tests (BATs). To review the potential and limitations of quantification of sIgE, mediator release, and BAT in anesthesia-related IHRs, a literature search was conducted using the key words allergy, basophil activation, CD63, CD203c, diagnosis, drugs, hypersensitivity, flow cytometry, MRGPRX2, specific IgE antibodies, leukotrienes, histamine, and tryptase; this was complemented by the authors' experience...
February 14, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29442057/inguinal-hernia-repair-in-day-surgery-the-role-of-mac-monitored-anesthesia-care-with-remifentanil
#7
P Palumbo, S Usai, C Amatucci, B Perotti, L Ruggeri, G Illuminati, G Tellan
BACKGROUND: The extension of indications for procedures in a Day Surgery (DS) setting has led to changes in the anesthetic and surgical treatment of Inguinal Hernias (IH). According to the recommendations of the European Hernia Society, the treatment of IH in DS units should be performed under Monitored Anesthesia Care (MAC). PATIENTS AND METHODS: 960 patients underwent IH repairs over a period of 24 months. The patients were randomly divided into two groups: R (remifentanil) and F (fentanyl); the group F was considered as a control group...
November 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29391825/tramadol-use-in-a-patient-with-brugada-syndrome-and-morphine-allergy-a-case-report
#8
Cengiz Sahutoglu, Seden Kocabas, Fatma Zekiye Askar
Brugada syndrome is a rare syndrome characterized by arrhythmias and sudden death, particularly in younger individuals. A mutation in a gene encoding the human cardiac sodium channels is responsible for this syndrome. In the literature, there are several case reports of Brugada syndrome in association with the use of several anesthetic agents. Herein, we present our anesthetic practice and the use of tramadol in a 75-year-old female patient who underwent pulmonary lobectomy under general anesthesia and was diagnosed with Brugada syndrome...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29390531/dexmedetomidine-based-monitored-conscious-sedation-combined-local-anesthesia-for-levator-resection-in-a-10-year-old-child-with-marcus-gunn-jaw-winking-synkinesis-a-case-report
#9
Ye Tu, Feng Gao
RATIONALE: Levator resection has become a routine procedure for patients with severe Marcus Gunn jaw-winking synkinesis (MGJWS). To optimize the surgical outcome, adult patients need to be kept awake, or easily aroused and responsive to verbal commands during the operation. However, levator resection is commonly performed under general anesthesia in pediatric patients. In the present case, we described a successful anesthetic protocol of conscious sedation with local anesthesia for levator resection in a child...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29349036/alternative-topical-anesthesia-for-bronchoscopy-in-a-case-of-severe-lidocaine-allergy
#10
Matthew Hensley, Benjamin H Singer
Lidocaine allergy presents a unique difficulty for both patients and providers who undergo/perform bronchoscopy. We present a case of a 73 yo male with severe lidocaine allergy who successfully underwent bronchoscopy with chloroprocaine topical anesthesia and discuss alternative topical anesthetic agents that may be used in this special situation.
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29326848/the-knowledge-of-eye-physicians-on-local-anesthetic-toxicity-and-intravenous-lipid-treatment-questionnaire-study
#11
Aykut Urfalıoğlu, Selma Urfalıoğlu, Gözen Öksüz
Objectives: To evaluate the knowledge of ophthalmologists regarding local anesthesia toxicity syndrome (LATS) and intravenous lipid emulsion used in treatment, and to raise awareness of this issue. Materials and Methods: A questionnaire comprising 14 questions about demographics, local anesthesia (LA) use, toxicity, and treatment methods was administered to ophthalmologists at different hospitals. Results: The study included 104 ophthalmologists (25% residents, 67...
December 2017: Turkish Journal of Ophthalmology
https://www.readbyqxmd.com/read/29278624/allergic-reactions-and-anesthesia
#12
Danijela Glibo Bevanda, Marko Čačić, Slobodan Mihaljević, Mateo Bevanda, Ante Bogut, Maja Karin
The diagnosis of allergic reactions during anesthesia is difficult. For example, cardio-respiratory symptoms may be due to the accompanying pharmacological effects of anesthetics and poor interpretation of the reaction during anesthesia. It is important to distinguish whether a real allergic reaction has occurred. Accidents with anesthetics and muscle relaxants are observed more often than we expect. Proper anaphylaxis rarely occurs during anesthesia (1: 20000). Muscle relaxants are the most common causes, followed by latex, chlorhexidine, antibiotics and opioids...
December 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/29274831/preoperative-cesarean-delivery-intravenous-acetaminophen-treatment-for-postoperative-pain-control-a-randomized-double-blinded-placebo-control-trial
#13
Craig V Towers, Sarah Shelton, Jaclyn van Nes, Emily Gregory, Emily Liske, Arion Smalley, Edward Mobley, Barbara Faircloth, Kim B Fortner
BACKGROUND: The United States currently has an opioid use disorder epidemic and research evaluating ways to minimize the use of opioids postsurgery are needed. One of these options is intravenous acetaminophen. If the use of preoperative intravenous acetaminophen was found to be effective for cesarean delivery, this would be beneficial for both the mother and breast-feeding neonate. OBJECTIVE: The primary study objective was to see if maternal opioid use was significantly less in the postoperative period for the study group that received 1 g of intravenous acetaminophen preoperatively compared with a control group that received placebo...
March 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29189281/improvement-of-the-elevated-tryptase-criterion-to-discriminate-ige-from-non-ige-mediated-allergic-reactions
#14
Gabriel Gastaminza, Alberto Lafuente, Maria Jose Goikoetxea, Carmen M D'Amelio, Amalia Bernad-Alonso, Olga Vega, Juan Ambrosio Martinez-Molina, Marta Ferrer, Jorge M Nuñez-Cordoba
BACKGROUND: Differentiating between immunoglobulin E (IgE)-dependent and IgE-independent hypersensitivity reactions may improve the etiologic orientation and clinical management of patients with allergic reactions in the anesthesia setting. Serum tryptase levels may be useful to discriminate the immune mechanism of allergic reactions, but the diagnostic accuracy and optimal cutpoint remain unclear.We aimed to compare the diagnostic accuracy of tryptase during reaction (TDR) alone and the TDR/basal tryptase (TDR/BT) ratio for discriminating IgE- from non-IgE-mediated allergic reactions, and to estimate the best cut point for these indicators...
November 17, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29189280/the-science-of-local-anesthesia-basic-research-clinical-application-and-future-directions
#15
Philipp Lirk, Markus W Hollmann, Gary Strichartz
Local anesthetics have been used clinically for more than a century, but new insights into their mechanisms of action and their interaction with biological systems continue to surprise researchers and clinicians alike. Next to their classic action on voltage-gated sodium channels, local anesthetics interact with calcium, potassium, and hyperpolarization-gated ion channels, ligand-gated channels, and G protein-coupled receptors. They activate numerous downstream pathways in neurons, and affect the structure and function of many types of membranes...
April 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29053033/hyaluronidase-allergy-mimicking-orbital-cellulitis
#16
Nirav D Raichura, Md Shahid Alam, V V Jaichandran, Saurabh Mistry, Bipasha Mukherjee
PURPOSE: Hyaluronidase enzyme is a common additive with local anesthetic agent to facilitate faster permeation of the anesthetic in periocular tissues during ophthalmic surgery. We report a series of five subjects presenting with clinical features mimicking orbital cellulitis following peribulbar anesthesia and consequently diagnosed with hyaluronidase hypersensitivity. SETTING: The study was conducted at a tertiary eye care center in Southern India. DESIGN: It was a retrospective interventional case series...
October 20, 2017: Orbit
https://www.readbyqxmd.com/read/29050061/-perioperative-anaphylaxia-on-drugs
#17
Wolfgang Pfützner, Hinnerk Wulf
The diagnostic evaluation of perioperative anaphylaxia is of great importance for the medical care of the affected persons in the context of renewed interventions in general anesthesia. The most frequent triggers include muscle relaxants, antibiotics, latex and analgesics of the type of the cyclooxygenase inhibitors, but other perioperatively administered drugs such as opioids, anesthetics, benzodiazepines, dyes, disinfectants and even corticosteroids or drug additives may also be the cause in rare cases. The most important aim is therefore the identification of the responsible drug, for which a near-time allergological diagnosis should be carried out within the first 4 weeks to 6 months after the reaction...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28893209/preliminary-experience-in-laparoscopic-resection-of-hepatic-hydatidectocyst-with-the-da-vinci-surgical-system-dvss-a-case-report
#18
Haibo Zou, Lanyun Luo, Hua Xue, Guan Wang, Xiankui Wang, Le Luo, Yutong Yao, Guangming Xiang, Xiaolun Huang
BACKGROUND: At present, Da Vinci robotic assisted hepatectomy has been routinely carried out in conditional units. But there is no report concerning the use of Da Vinci robots for hepatic hydatid cystectomy and experience on this aspect is seldom mentioned before. This study was to summarize the preliminary experience in laparoscopic resection of hepatic hydatidectocyst with the Da Vinci Surgical System (DVSS). CASE PRESENTATION: A 29-year-old female diagnosed as hepatic hydatid in the right anterior lobe of liver was treated with laparoscopic resection by the DVSS under general anesthesia...
September 11, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28876979/general-anaesthesia-for-patients-with-a-history-of-a-contrast-medium-induced-anaphylaxis-a-useful-prophylaxis
#19
REVIEW
Ingrid Boehm, Knud Nairz, John Morelli, Patricia Silva Hasembank Keller, Johannes Thomas Heverhagen
Contrast-enhanced radiological examinations are important diagnostic tools in modern medicine. Currently, all approved and available iodinated and gadolinium-based contrast agents are safe and well-tolerated by most patients. However, approximately 2% of patients receiving iodinated contrast media exhibit hypersensitivity reactions. Patients with a history of such a reaction are at increased risk upon reexposure. Therefore, they are subjected to a prophylaxis such as injection of antiallergy drugs or general anaesthesia...
November 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28866307/evaluation-of-periprocedural-hypersensitivity-reactions
#20
Melissa Iammatteo, Taha Keskin, Elina Jerschow
BACKGROUND: Identifying the cause of periprocedural hypersensitivity reactions (HSRs) remains challenging because of the multitude of medications involved. Antibiotics are the most common cause in the United States, whereas neuromuscular blocking agents are most common in Europe. OBJECTIVE: To identify causative agents for periprocedural HSRs. METHODS: This study was a 7-year retrospective medical record review of patients evaluated between December 2009 and January 2017 at a drug allergy center in Bronx, New York for periprocedural HSRs, defined as occurring soon before, during, or soon after a medical procedure or operation with or without general anesthesia...
October 2017: Annals of Allergy, Asthma & Immunology
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