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Allergic anesthesia

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https://www.readbyqxmd.com/read/28799727/cryosurgical-posterior-nasal-tissue-ablation-for-the-treatment-of-rhinitis
#1
Peter H Hwang, Bryant Lin, Raymond Weiss, James Atkins, Jacob Johnson
BACKGROUND: Endoscopic posterior nasal nerve (PNN) resection has been described as an efficacious surgical treatment of allergic and nonallergic rhinitis, but the requirement for surgery under general anesthesia has limited its acceptance. We report the first series of patients treated for chronic rhinitis using a novel device designed for office-based cryosurgical ablation of the PNN. METHODS: Twenty-seven patients with chronic rhinorrhea and/or nasal congestion for >3 months were recruited (allergic or nonallergic rhinitis), with minimum rhinorrhea and/or congestion subscores of 2 as part of the Total Nasal Symptom Score [TNSS])...
August 11, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28717055/incidence-of-anaphylactic-reactions-after-propofol-administration-in-dogs
#2
Mamoru Onuma, Misao Terada, Sadaharu Ono, Akiyoshi Murakami, Tomoko Ishida, Tadashi Sano
Propofol is an anesthetic agent suspended in an emulsion system that includes egg yolk lecithin and soybean oil, because of which, there is concern about the use of propofol in patients allergic to these substances. We examined the association between propofol administration and incidence of adverse events in dogs with allergy to egg yolk lecithin and soybean oil. On the basis of the findings of an allergen-specific immunoglobulin E (IgE) test, 14 dogs with high levels (high-IgE group) and 7 dogs with low levels (normal-IgE group) of IgE were selected...
July 14, 2017: Journal of Veterinary Medical Science
https://www.readbyqxmd.com/read/28580612/utility-of-basophil-activation-testing-to-assess-perioperative-anaphylactic-reactions-in-real-world-practice
#3
Bernadette Eberlein, Sibylle Wigand, Heidrun Lewald, Eberhard Kochs, Johannes Ring, Tilo Biedermann, Ulf Darsow
INTRODUCTION: Perioperative anaphylactic reactions due to drugs and substances associated with general anesthesia can potentially be life-threatening. The objective of this study was to investigate the significance of the basophil activation test (BAT) for allergy diagnosis work up. METHODS: A total of 14 patients (5 men, 9 women; mean age: 57.8 years) with clinical records of anaphylactic reactions under general anesthesia were studied by means of anesthesia records, skin and serological tests...
June 5, 2017: Immunity, Inflammation and Disease
https://www.readbyqxmd.com/read/28550985/opioid-hypersensitivity-predictors-of-allergy-and-role-of-drug-provocation-testing
#4
Philip H Li, Kok Loong Ue, Annette Wagner, Ryszard Rutkowski, Krzysztof Rutkowski
BACKGROUND: True IgE-mediated hypersensitivity to opioids is rare and many reactions are due to direct mast cell degranulation. Opioid drug provocation testing (DPT) is the gold standard for diagnosis but is underutilized. OBJECTIVE: The objective of this study was to evaluate the clinical characteristics and predictors of opioid hypersensitivity, as well as outcomes of opioid DPT. METHODS: Patients referred for opioid DPT over the past 9 years were studied...
May 24, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28301644/association-of-body-mass-index-with-infectious-complications-in-free-tissue-transfer-for-head-and-neck-reconstructive-surgery
#5
Mohemmed N Khan, Jack Russo, John Spivack, Christopher Pool, Ilya Likhterov, Marita Teng, Eric M Genden, Brett A Miles
Importance: Elevated body mass index (BMI) has been proposed as a risk factor for morbidity and mortality among patients undergoing surgery. Conversely, an elevated BMI may confer a protective effect on perioperative morbidity. Objective: To examine whether an elevated BMI is an independent risk factor for perioperative and postoperative infectious complications after free tissue transfer in head and neck reconstructive surgery. Design, Setting, and Participants: This cohort study included patients undergoing major head and neck surgery requiring free tissue transfer at a tertiary care center...
June 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28301407/in-vivo-cysteinyl-leukotriene-release-in-allergic-and-nonallergic-immediate-hypersensitivity-reactions-during-anesthesia
#6
Dominique Laroche, Pierre Léturgie, Delphine Mariotte, Yann Ollivier, Jean-Luc Hanouz, Brigitte Le Mauff, Jean-Jacques Parienti
BACKGROUND: Immediate hypersensitivity reactions occurring during anesthesia are classified as allergic when skin tests and mast cell tryptase are positive and as nonallergic when negative results are obtained. Cysteinyl leukotrienes (cysLTs) are potent mediators synthesized by mast cell and eosinophil that induce bronchial constriction. They could play a role in hypersensitivity reactions. METHODS: cysLT C4, D4, and E4 concentrations were measured by a competition immunoassay in serial plasma samples obtained prospectively from 21 anesthetized controls and retrospectively from 34 patients who reacted at induction of anesthesia (24 with allergic and 10 with nonallergic reactions)...
May 2017: Anesthesiology
https://www.readbyqxmd.com/read/28300520/hypnosis-as-a-valuable-tool-for-surgical-procedures-in-the-oral-and-maxillofacial-area
#7
Gil Montenegro, Luiza Alves, Ana Luiza Zaninotto, Denise Pinheiro Falcão, Rivadávio Fernandes Batista de Amorim
Hypnosis is a valuable tool in the management of patients who undergo surgical procedures in the maxillofacial complex, particularly in reducing and eliminating pain during surgery and aiding patients who have dental fear and are allergic to anesthesia. This case report demonstrates the efficacy of hypnosis in mitigating anxiety, bleeding, and pain during dental surgery without anesthesia during implant placement of tooth 14, the upper left first molar.
April 2017: American Journal of Clinical Hypnosis
https://www.readbyqxmd.com/read/28244622/perioperative-considerations-for-the-food-allergic-pediatric-patient
#8
REVIEW
Patrick G Fernandez, Marco Mikhael
Patients with a history of food allergy and food intolerance are common in the pediatric population and are encountered frequently in the perioperative setting by pediatric anesthesiologists. Perioperatively, food allergy can present on a spectrum ranging from minor acute urticaria to more severe hypovolemia and anaphylactic shock. Allergy to foods including fruits, fish, egg, soy, and peanut are most concerning for their potential to cross-react with perioperative medications. There is little in the anesthesia literature that focuses on the perioperative management of children with food allergies...
May 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28214316/pre-and-perioperative-aspects-of-dermatosurgery
#9
Cornelia S L Müller, Wakiko Hubner, Sigrid Thieme-Ruffing, Claudia Pföhler, Thomas Vogt, Thomas Volk, Barbara C Gärtner, Patric Bialas
Dermatosurgery occupies an exceptional position among all surgical disciplines. Above all, this includes the fact that, with very few exceptions, the vast majority of surgical interventions can be performed under local or regional anesthesia, usually in smaller procedure rooms that are spatially separated from larger operating suites. Thus, peri- and postinterventional patient monitoring is the responsibility of the dermatosurgeon and his team. Though inherently smaller, this team still has to observe numerous perioperative requirements that - in larger surgical specialties - would be attended to by a host of various specialists working in concert...
February 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28181948/kounis-syndrome-during-anesthesia-presentation-of-indolent-systemic-mastocytosis-a-case-report
#10
Elena de la Fuente Tornero, Arantza Vega Castro, Pedro Álvarez de Sierra Hernández, Javier Balaguer Recena, Sofía Carmen Zaragoza Casares, Francisco Miguel Serrano Baylin, Paloma Gallardo Culebradas, Beatriz Amorós Alfonso, Jose Ramón Rodríguez Fraile
Mastocytosis comprises a heterogeneous group of disorders characterized by mast cell accumulation and proliferation in distinct organs. Kounis syndrome is defined as the concurrence of acute coronary syndromes with mast cell activation in a setting of allergic or hypersensitivity reactions. This is the first reported case of an intraoperative Kounis syndrome as the onset of an indolent systemic mastocytosis probably triggered by succinylated gelatin infusion during general anesthesia. The presentation of this case is intended to contribute to the knowledge of mastocytosis and Kounis syndrome at the time of diagnostic workup during intraoperative anaphylaxis or myocardial ischemia...
May 1, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28108822/the-feasibility-of-local-anesthesia-for-the-surgical-treatment-of-umbilical-hernia-a-systematic-review-of-the-literature
#11
REVIEW
A P Jairam, R Kaufmann, F Muysoms, J Jeekel, J F Lange
BACKGROUND: Yearly approximately 4500 umbilical hernias are repaired in The Netherlands, mostly under general anesthesia. The use of local anesthesia has shown several advantages in groin hernia surgery. Local anesthesia might be useful in the treatment of umbilical hernia as well. However, convincing evidence is lacking. We have conducted a systematic review on safety, feasibility, and advantages of local anesthesia for umbilical hernia repair. METHODS: A systematic review was conducted according to the PRISMA guidelines...
April 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/27916062/-perioperational-management-of-gynecological-cancer-patients-with-severe-internal-medical-complications-a-serial-of-37-clinical-cases
#12
J Hu, W Q Lyu, Y L Guo, H W Wen, H Qiao, Y Qu
Objective: To evaluate the effectiveness and safety of perioperational management of gynecological cancer patients with severe internal medical complications. Methods: We collected 37 cases of gynecological cancer patients with severe internal medical complications who were hospitalized in Peking University First Hospital from Jan. 2010 to Nov. 2014. All of the cases were planned to move to ICU right after operation based on the preoperational assessment of anesthetist and physician. The median age was 69.4 years, and 25 cases (68%,25/37) of them were over 70 years old...
November 25, 2016: Zhonghua Fu Chan Ke za Zhi
https://www.readbyqxmd.com/read/27691969/medical-management-of-recurrent-eosinophilic-granuloma-in-two-black-rhinoceros-diceros-bicornis
#13
Greg T Bishop, Jeffery R Zuba, Allan P Pessier, Jane Hopper, Gloria Kendall, Rod A W Rosychuk, K Gary Magdesian
Recurrent eosinophilic granuloma (EG) in two captive eastern black rhinoceros ( Diceros bicornis michaeli) was effectively managed with glucocorticoids and antihistamines. The first case was a female and the second case was a male. The animals were housed at separate institutions and initially presented with hemorrhagic oral lesions. Multifocal lesions occurred in the second case. Multiple biopsies were taken from each animal, all of which were consistent with EG. Each animal was anesthetized multiple times for surgical treatment but experienced frequent recurrence...
September 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/27625354/safe-use-of-subcutaneous-diphenhydramine-in-the-inpatient-hospice-unit
#14
Aileen Chen, Erwin J Loquias, Ramesh Roshan, Richard Levene, Raymond Zelhof, Terry Hickey, Gail Austin Cooney, Faustino Gonzalez
BACKGROUND: Diphenhydramine (DPH) is most commonly used via oral, topical, intramuscular (IM) and intravenous (IV) routes for the palliation of pruritus, treatment of extrapyramidal symptoms, management of parkinsonism and for allergic reactions. However, many hospice patients are unable to take oral medications and/or do not have IV access. Moreover, topical administration has a relatively slow rate of absorption. For this reason, in the hospice setting it is not uncommon for diphenhydramine to be administered via the subcutaneous (SC) route secondary to its ease of access, low infection rates and its low levels of discomfort...
January 1, 2016: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/27434310/dermographism-a-rare-cause-of-intraoperative-hypotension-and-urticaria
#15
Mark Burbridge
A 54-year-old man with dermographism presented for spine surgery, and shortly after induction of anesthesia, he experienced severe hypotension and urticaria, resulting in cancellation of the case on suspicion of allergic reaction. For subsequent ventral hernia repair, a perioperative management strategy was devised, which resulted in an uneventful perioperative course. This case report is the first to demonstrate severe intraoperative hypotension and urticaria from dermographism. We discuss the strategy that made the subsequent surgery a success and provide guidance for practitioners who face a patient with a severe form of this chronic disease...
July 15, 2016: A & A Case Reports
https://www.readbyqxmd.com/read/27428241/general-anesthesia-exposure-in-early-life-reduces-the-risk-of-allergic-diseases-a-nationwide-population-based-cohort-study
#16
Ho-Chang Kuo, Ya-Ling Yang, Shu-Chen Ho, Mindy Ming-Huey Guo, Jyun-Hong Jiang, Ying-Hsien Huang
General anesthesia (GA) has been used for second line treatment strategy for status asthmaticus in pediatric patients. The association between GA in children and risk of followed-up allergic diseases is unclear. This study aims to assess the risk of allergic diseases after GA in children.We did a nationwide retrospective cohort study by analyzing data from the National Health Insurance Research Database (NHIRD) in Taiwan. The subsequent risks for allergic diseases, including asthma (ICD-9: 493.X), allergic rhinitis (AR; ICD-9 CM code 477...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27374263/diagnostic-procedure-after-an-immediate-hypersensitivity-reaction-in-the-operating-room
#17
Charles Tacquard, Dominique Laroche, Rodolphe Stenger, Delphine Mariotte, Béatrice Uring-Lambert, Frédéric De Blay, Jean-Marc Malinovsky, Paul Michel Mertes
The diagnosis of a perioperative allergic reaction is based on clinical features associated with a suggestive timeline, the exclusion of other diagnoses, elevated concentrations of degranulation markers (histamine, tryptase), and positive allergy assessments (skin tests, specific IgE). After initiating appropriate treatment, the anesthesiologist should take blood samples to measure histamine and tryptase concentrations just after the reaction and repeat them 1-2hours later to validate the diagnosis of immediate hypersensitivity...
September 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27324891/takotsubo-cardiomyopathy-and-its-relevance-to-anesthesiology-a-narrative-review
#18
REVIEW
Eugene A Hessel
PURPOSE: Takotsubo cardiomyopathy (TTCM) is a form of stress cardiomyopathy that may occur in the perioperative period and among the critically ill. Therefore, anesthesiologists should be aware of its diagnosis and treatment. The aim of this narrative review is describe the features of TTCM and its relevance to the practice of anesthesiology. PRINCIPAL FINDINGS: Takotsubo cardiomyopathy occurs in about 2-9/100,000 persons in the general population annually and may occur in up to one in 6,700 cases in the perioperative period...
September 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27290941/a-case-of-anaphylaxis-apparently-induced-by-sugammadex-and-rocuronium-in-successive-surgeries
#19
Yuko Yamada, Takuji Yamamoto, Kumiko Tanabe, Naokazu Fukuoka, Motoyasu Takenaka, Hiroki Iida
Rocuronium is the agent most frequently involved in perioperative anaphylaxis, and sugammadex has also been known to induce anaphylactic reactions. We describe a case of successive anaphylactic episodes that seemed to be induced by clinical doses of rocuronium and sugammadex. The patient was a 19-year-old woman who had a medical history of asthma, but no history of surgery. She had been injured in a fall, and several surgeries were scheduled for multiple bone fractures. At the first surgery under general anesthesia, she developed anaphylaxis 5 min after sugammadex administration...
August 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27190922/optimal-dose-of-intrathecal-dexmedetomidine-in-lower-abdominal-surgeries-in-average-indian-adult
#20
Shagufta Naaz, Jahanara Bandey, Erum Ozair, Adil Asghar
BACKGROUND: Dexmedetomidine, a selective alpha2 adrenoceptor agonist, has been used as adjuvant to spinal anaesthesia. AIM: To find out the optimum dose of dexmedetomidine to be used in lower abdomen surgery intrathecally. MATERIALS AND METHODS: This was a randomized, controlled, double blinded study which included adult ASA I and II patients. They were allocated into five groups (n=20). Patients allergic to drugs to be used in the study and those with co-existing neurological disorders, coagulopathies, cardiac diseases, obesity and hypertension were excluded...
April 2016: Journal of Clinical and Diagnostic Research: JCDR
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