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[¿Anafilaxia perioperatoria? Serie de casos].
Revista Alergia Mexico : Organo Oficial de la Sociedad Mexicana de Alergia e Inmunología, A.C 2023 September
OBJECTIVE: Identify the causative agent of POH, to avoid re-exposure and assess the use of alternative treatment.
METHODS: 10 cases of immediate POH are described, in all of them a history of previous surgical procedures, carrying out a 3-step protocol: 1st documenting the surgical record to identify exposures, 2nd performing skin and/or epicutaneous tests and 3rd searching for an alternative treatment. treatment if a new surgical procedure is required and in selected cases challenge tests.
RESULTS: Of a total of 10 patients with immediate POH, tests were performed according to the case: neuromuscular blockers, anesthetics, opioids, NSAIDs, anti- biotics, diuretics, latex, isodine, and chlorhexidine; finding positive tests in 7 (70%) patients: in 4 (40%) neuromuscular blockers, one of them also positive for latex, in 2 (20%) anesthetics and finally finding a pharmacological alternative in 2 (2%) and recommending free operating room latex in 2 cases (20%), the rest (30%) were classified as related to the surgical procedure and medication management.
CONCLUSIONS: The study of POH is focused on ensuring safety in subsequent exposures, so in addition to identifying the causative agent, the role of the allergist also leads to a search for a safe alternative in patient management.
METHODS: 10 cases of immediate POH are described, in all of them a history of previous surgical procedures, carrying out a 3-step protocol: 1st documenting the surgical record to identify exposures, 2nd performing skin and/or epicutaneous tests and 3rd searching for an alternative treatment. treatment if a new surgical procedure is required and in selected cases challenge tests.
RESULTS: Of a total of 10 patients with immediate POH, tests were performed according to the case: neuromuscular blockers, anesthetics, opioids, NSAIDs, anti- biotics, diuretics, latex, isodine, and chlorhexidine; finding positive tests in 7 (70%) patients: in 4 (40%) neuromuscular blockers, one of them also positive for latex, in 2 (20%) anesthetics and finally finding a pharmacological alternative in 2 (2%) and recommending free operating room latex in 2 cases (20%), the rest (30%) were classified as related to the surgical procedure and medication management.
CONCLUSIONS: The study of POH is focused on ensuring safety in subsequent exposures, so in addition to identifying the causative agent, the role of the allergist also leads to a search for a safe alternative in patient management.
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