keyword
https://read.qxmd.com/read/32476042/interpreting-the-results-of-early-skin-tests-after-perioperative-anaphylaxis-requires-special-attention-a-case-report-and-review-of-literature
#21
JOURNAL ARTICLE
Masaki Orihara, Tomonori Takazawa, Kazuhiro Nagumo, Shinya Sakamoto, Tatsuo Horiuchi, Shigeru Saito
Skin tests are the gold standard for detecting the culprit drug of anaphylaxis, and should ideally be performed after an interval of 4-6 weeks after the reaction to avoid false-negative results. However, when re-operation cannot be delayed and early allergy tests are necessary, special attention is required during subsequent anesthesia, because early skin tests tend to produce false-negative results. This report presents a case of rocuronium-induced anaphylaxis in which early skin tests showed negative results for all the drugs tested...
May 31, 2020: Journal of Anesthesia
https://read.qxmd.com/read/32008289/-analysis-of-sugammadex-for-antagonistic-neuromuscular-block-in-patients-with-radical-resection-of-lung-cancer-under-thoracoscope
#22
RANDOMIZED CONTROLLED TRIAL
Y F Ba, Y N Liu, S H He, H M Li, H R Wang, J P Zhu, W Q Xing, C S Li
Objective: To investigate the efficacy and safety of sugammadex for antagonistic neuromuscular block in patients with radical resection of lung cancer under thoracoscope. Methods: One hundred patients undergoing radical resection of lung cancer under thoracoscope in Affiliated Cancer Hospital of Zhengzhou University from March to September in 2019, were randomly divided into control group (group C) and sugammadex group (group S). All patients were anaesthetized (induced and maintained) with intravenous target-controlled infusion of propofol and remifentanil, and intermittent intravenous injection of the neuromuscular block of rocuronium...
January 21, 2020: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://read.qxmd.com/read/31058590/general-anesthetics-drug-challenge-tests-predictive-value-of-skin-tests
#23
JOURNAL ARTICLE
P Tornero Molina, P Rojas-Perez-Ezquerra, B Noguerado-Mellado, M L Baeza Ochoa de Ocáriz, A Garrido Sánchez, M Alonso Mateos, J M Zubeldia Ortuño
BACKGROUND AND OBJECTIVE: The study of perioperative drug reactions remains a major challenge both for diagnosis and therapeutic management. Lack of standardization of the study of allergy to general anesthetics and nonexistence of data establishing the true value of skin tests for the majority of drugs used in anesthesia induction and maintenance, as well as the lack of commercially available reagents to perform in vitro tests, is a continuous dilemma in the study of these reactions...
May 6, 2019: Journal of Investigational Allergology & Clinical Immunology
https://read.qxmd.com/read/30961915/assessing-cross-reactivity-to-neuromuscular-blocking-agents-by-skin-and-basophil-activation-tests-in-patients-with-neuromuscular-blocking-agent-anaphylaxis
#24
JOURNAL ARTICLE
Jamma Li, Oliver G Best, Michael A Rose, Sarah L Green, Richard B Fulton, Marc J Capon, Benedict A Krupowicz, Suran L Fernando
BACKGROUND: Following diagnosis of neuromuscular blocking agent (NMBA) anaphylaxis, identifying safe alternatives for subsequent anaesthesia is critical. A patient with anaphylaxis to one NMBA can also have an allergic reaction to other NMBAs (cross-reactivity). Whilst drug provocation testing is standard for identifying or excluding allergy, there is significant risk. In vitro, after an allergen activates basophils, basophils express surface activation markers that can be measured by basophil activation testing (BAT)...
July 2019: British Journal of Anaesthesia
https://read.qxmd.com/read/30864360/opioid-free-anesthesia-for-laparotomic-hemicolectomy-a-case-report
#25
JOURNAL ARTICLE
Marija Toleska, Biljana Kuzmanovska, Andrijan Kartalov, Mirjana Shosholcheva, Jasminka Nancheva, Aleksandar Dimitrovski, Natasha Toleska
Opioid free anesthesia (OFA) is deffined as anaesthesiological technique where opioids are not used in the intraoperative period (systemic, neuroaxial or intracavitary). Anaphylaxis caused by opioids (fentanyl) is very rare, and the reaction is presented with hypotension and urticaria. When we have proven allergy to fentanyl, patients' refusal of placing epidural catheter and refusal of receiving bilateral ultrasound guided transversus abdominis plane block (USG TAPB), we must think of using multimodal nonopioide analgesia...
December 1, 2018: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://read.qxmd.com/read/29921087/negative-association-between-previous-allergy-and-intradermal-tests-for-rocuronium-and-cisatracurium-what-about-additional-tests
#26
JOURNAL ARTICLE
Nicholas G Kounis, Ioanna Koniari, Emmanouil Chourdakis, Periklis Davlouros, George Hahalis
No abstract text is available yet for this article.
August 2018: Korean Journal of Anesthesiology
https://read.qxmd.com/read/29878947/deep-neuromuscular-blockade-and-surgical-conditions-during-laparoscopic-ventral-hernia-repair-a-randomised-blinded-study
#27
JOURNAL ARTICLE
Carl M Söderström, Roar Borregaard Medici, Sami Assadzadeh, Søren Følsgaard, Jacob Rosenberg, Mona R Gätke, Matias V Madsen
BACKGROUND: Laparoscopic ventral hernia repair is a common surgical procedure. However, muscle contractions and general muscle tension may impair the surgical view and cause difficulties suturing the hernial defect. Deep neuromuscular blockade (NMB) paralyses the abdominal wall muscles and may help to create better surgical conditions. OBJECTIVES: The current study investigated if deep compared with no NMB improved the surgical view during laparoscopic ventral hernia repair...
November 2018: European Journal of Anaesthesiology
https://read.qxmd.com/read/29684989/intradermal-skin-tests-for-rocuronium-and-cisatracurium-in-patients-with-a-history-of-allergy-a-retrospective-study
#28
JOURNAL ARTICLE
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...
August 2018: Korean Journal of Anesthesiology
https://read.qxmd.com/read/28818054/comparison-of-the-trapezius-and-the-adductor-pollicis-muscle-as-predictor-of-good-intubating-conditions-a-randomized-controlled-trial
#29
RANDOMIZED CONTROLLED TRIAL
Stefan Soltesz, Christian Stark, Karl G Noé, Michael Anapolski, Thomas Mencke
BACKGROUND: Adequate muscle relaxation is important for ensuring optimal conditions for intubation. Although acceleromyography of the adductor pollicis muscle is commonly used to assess conditions for intubation, we hypothesized that acceleromyography of the trapezius is more indicative of optimal intubating conditions. The primary outcome was the difference between both measurement sites with regard to prediction of good or acceptable intubating conditions. METHODS: Neuromuscular blockade after injection of rocuronium 0...
August 17, 2017: BMC Anesthesiology
https://read.qxmd.com/read/28483312/current-knowledge-and-management-of-hypersensitivity-to-perioperative-drugs-and-radiocontrast-media
#30
JOURNAL ARTICLE
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...
2017: Journal of Allergy and Clinical Immunology in Practice
https://read.qxmd.com/read/28258478/in-vitro-diagnosis-of-immediate-drug-hypersensitivity-anno-2017-potentials-and-limitations
#31
REVIEW
I I Decuyper, E A Mangodt, A L Van Gasse, K Claesen, A Uyttebroek, M Faber, V Sabato, C H Bridts, C Mertens, M M Hagendorens, L S De Clerck, Didier G Ebo
BACKGROUND: For most physicians, quantification of drug-specific immunoglobulin E (drug-sIgE) antibodies constitutes the primary in vitro measure to document immediate drug hypersensitivity reactions (IDHR). Unfortunately, this is often insufficient to correctly identify patients with IgE-mediated IDHR and impossible for non-IgE-mediated IDHR that result from alternative routes of basophil and mast cell activation. In these difficult cases, diagnosis might benefit from cellular tests such as basophil activation tests (BAT)...
June 2017: Drugs in R&D
https://read.qxmd.com/read/28235514/atypical-presentation-to-rocuronium-allergy-in-a-19-year-old-female-patient
#32
JOURNAL ARTICLE
Vladimir Kuric, Khaled J Zaza, Sulaiman S Algazlan
The danger of anaphylaxis, a rare but life threatening complication of general anesthesia (GA) can be summarized in two: 1. General Anesthesia masks the typical early signs of allergy which can be seen in an awake patient. 2. Anaphylaxis during GA manifests mostly as circulatory/ventilatory failures which can be interpreted as adverse effects of anesthetics or surgery and this can lead to critical delay of effective therapy. A 19-year-old female admitted for posterior spinal fusion and instrumentation (the 5th surgery in patient's life) desaturated seconds after intubation...
February 2017: Journal of Clinical Anesthesia
https://read.qxmd.com/read/28164269/anaesthetic-hypersensitivity-reactions-in-france-between-2011-and-2012-the-10th-gerap-epidemiologic-survey
#33
JOURNAL ARTICLE
C Tacquard, O Collange, P Gomis, J-M Malinovsky, N Petitpain, P Demoly, S Nicoll, P M Mertes
BACKGROUND: Immediate hypersensitivity reactions during anaesthesia are rare but potentially life-threatening. The epidemiology changes with time and evolving professional practice, and hence needs to be monitored. Our objective was to follow this epidemiology. METHODS: This was a retrospective, observational study in French hospital clinics, conducted by GERAP members (Groupe d'Étude des Réactions Anaphylactoïdes Périopératoires). Consecutive patients seen in allergo-anaesthesia outpatient clinics, who had experienced a hypersensitivity reaction during anaesthesia between 1 January 2011 and 31 December 2012, were included...
March 2017: Acta Anaesthesiologica Scandinavica
https://read.qxmd.com/read/27646937/effects-of-different-doses-of-remifentanil-on-hemodynamic-response-to-anesthesia-induction-in-healthy-elderly-patients
#34
RANDOMIZED CONTROLLED TRIAL
Nilay Boztas, Sermin Oztekin, Sevda Ozkardesler, Mert Akan, Sule Ozbilgin, Ayse Baytok
OBJECTIVE: We compared the effects of three different doses of remifentanil infusion, which were performed for the induction of anesthesia in elder patients, on cardiovascular response. RESEARCH DESIGN AND METHODS: The present study was designed as a randomized, prospective and double-blind study. A total of 90 ASA I-II patients over the age of 65 years were enrolled. The patients were randomly (by lot) assigned to receive one of the three doses of remifentanil infusion (0...
January 2017: Current Medical Research and Opinion
https://read.qxmd.com/read/27606613/influence-of-preoperative-oral-rehydration-on-arterial-plasma-rocuronium-concentrations-and-neuromuscular-blocking-effects-a-randomised-controlled-trial
#35
RANDOMIZED CONTROLLED TRIAL
Sayaka Ishigaki, Takahiro Ogura, Ayana Kanaya, Yu Miyake, Kenichi Masui, Tomiei Kazama
BACKGROUND: The influence of preoperative rehydration on the action of rocuronium has not yet been investigated. OBJECTIVE: The objective is to evaluate the hypothesis that preoperative rehydration lowers arterial rocuronium plasma concentrations and changes its associated neuromuscular blocking effects during induction of anaesthesia. DESIGN: Randomised, single-blinded study. SETTING: A secondary hospital from October 2013 to July 2014...
January 2017: European Journal of Anaesthesiology
https://read.qxmd.com/read/27382817/peri-anesthesia-anaphylaxis-paa-we-still-have-not-started-post-paa-testing-for-inciting-anesthesia-related-allergens
#36
JOURNAL ARTICLE
Taghreed Alshaeri, Deepak Gupta, Ananthamurthy Nagabhushana
Anaphylaxis during anesthesia is uncommon. Diagnosis of peri-anesthesia anaphylaxis (PAA) requires anesthesia providers' vigilance for prompt diagnosis and treatment. In this case report, we present a challenging case with suspected PAA including its perioperative management, intensive care unit (ICU) course, and post-discharge follow-up. A 44-year-old female (body mass index = 26) presented for elective abdominal panniculectomy. Post-intubation, severe bronchospasm occurred that was non-responsive to nebulized albuterol and intravenous epinephrine...
February 2016: Middle East Journal of Anesthesiology
https://read.qxmd.com/read/27376983/quantification-of-specific-ige-antibodies-in-immediate-drug-hypersensitivity-more-shortcomings-than-potentials
#37
REVIEW
I I Decuyper, D G Ebo, A P Uyttebroek, M M Hagendorens, M A Faber, C H Bridts, L S De Clerck, V Sabato
BACKGROUND: For many physicians, quantification of serum drug-specific IgE (sIgE) antibodies constitutes the first measure in the diagnostic approach of immediate drug hypersensitivity reactions (IDHR). AIM: To review the accuracy and limitations of the main drug-sIgE tests, especially those that are commercially available. METHODS: A literature search was conducted, using the key-words allergy, diagnosis, drugs, hypersensitivity, specific IgE antibodies; this was complemented by the authors' own experience...
September 1, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://read.qxmd.com/read/27246945/early-skin-and-challenge-testing-after-rocuronium-anaphylaxis
#38
JOURNAL ARTICLE
E M Schulberg, A R Webb, H Kolawole
We present a case of early skin and challenge testing in a patient following severe anaphylaxis to rocuronium. The patient presented for semi-elective laparoscopic cholecystectomy and developed anaphylaxis with severe cardiovascular collapse after induction of anaesthesia. Surgery was cancelled but was considered necessary before the recommended four to six weeks for formal allergy testing. Limited skin and challenge testing was performed to rocuronium and cisatracurium while the patient was in the intensive care unit to identify a safe neuromuscular blocking drug for subsequent early surgery...
May 2016: Anaesthesia and Intensive Care
https://read.qxmd.com/read/27234905/-allergy-to-neuromuscular-blocking-agents
#39
JOURNAL ARTICLE
Anca-Mirela Chiriac, Pascal Demoly
Allergy to neuromuscular blocking agents (NMBAs) has been the first cause of perioperative anaphylaxis for decades, in most countries. The most frequently involved agents are suxamethonium and rocuronium. The allergy work-up is compulsory to demonstrate or rule out allergy to NMBAs, if there is a compatible clinical history. Doing otherwise exposes the patient to death if the same or related NMBA is re-injected. In cases of true allergy, assessing cross-reactivity to other NMBAs is mandatory. The cross-sensitization hypothesis is presently being investigated and if confirmed, it could allow primary prevention measures to be implemented...
September 2016: La Presse Médicale
https://read.qxmd.com/read/26666489/antibiotic-induced-immediate-type-hypersensitivity-is-a-risk-factor-for-positive-allergy-skin-tests-for-neuromuscular-blocking-agents
#40
JOURNAL ARTICLE
Natalia Hagau, Nadia Gherman, Mihaela Cocis, Cristina Petrisor
BACKGROUND: Skin tests for neuromuscular blocking agents (NMBAs) are not currently recommended for the general population undergoing general anaesthesia. In a previous study we have reported a high incidence of positive allergy tests for NMBAs in patients with a positive history of non-anaesthetic drug allergy, a larger prospective study being needed to confirm those preliminary results. The objective of this study was to compare the skin tests results for patients with a positive history of antibiotic-induced immediate type hypersensitivity reactions to those of controls without drug allergies...
January 2016: Allergology International: Official Journal of the Japanese Society of Allergology
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