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Anästhesie bei allergischer Diathese

Allergische Diathese, typische Auslöser in der perioperativen Phase, perioperative Prophylaxe

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Weiterbildung für Anästhesisten 2002

Zusammenfassung

Anaphylaktische Reaktionen treten während Anästhesie bei ca. 1 von 13.000 Patienten auf. Grundsätzlich können alle Substanzen, die zur Anästhesie eingesetzt werden, Anaphylaxien auslösen. Häufigste Auslöser sind jedoch Muskelrelaxanzien, Naturlatex und Antibiotika. Eine ausführliche Anamnese bezüglich Allergien, atopischen Vorerkrankungen und berufsbedingtem Risiko sowie in ausgewählten Fällen eine präoperative Allergietestung sind Voraussetzung für eine konsequente Antigenvermeidung und Substitution durch geeignete Substanzen. Als Besonderheit ist bei Patienten mit Spina bifida prinzipiell die Durchführung einer Anästhesie in naturlatexfreier Umgebung zu empfehlen. Zusätzlich ist bei positiver Anamnese schwerer Reaktionen eine medikamentöse Prophylaxe mit H1 und H2-Antagonisten, unter strenger Indikationsstellung evtl. auch mit Glukokortikoiden, sinnvoll. Tritt während Anästhesie eine schwere Anaphylaxie auf, ist die Antigenzufuhr zu stoppen und als wesentlicher Bestandteil der medikamentösen Therapie Adrenalin intravenös zu verabreichen sowie für einen ausreichenden intravasalen Volumenersatz zu sorgen. An zweiter Stelle stehen die Inhalation von β2-Agonisten, bzw. Fenoterol oder Adrenalin bei Bronchospasmus, sowie die intravenöse Gabe von H1 und H2-Rezeptorantagonisten und Glukokortikoiden.

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Literatur

  1. Ahnefeld FW, Barth J, Dick W et al. (1994) Acute therapy of anaphylactoid reactions. Results of an intradisciplinary consensus conference. Anaesthesist 43:211–222

    Article  PubMed  CAS  Google Scholar 

  2. Arellano R, Bradley J, Sussman G (1992) Prevalence of latex sensitization among hospital physicians occupationally exposed to latex gloves. Anesthesiology 77:905–908

    Article  PubMed  CAS  Google Scholar 

  3. Bailer D, Huchzermeyer H (1989) Histamine effects on the heart with special reference to cardiac side effects of H2 receptor antagonists. Klin Wochenschr 67:743–755

    Article  Google Scholar 

  4. Bundesministerium für Arbeit und Soziales (1997) Neue TRGS 540: Technische Regel für Gefahrenstoffe. Sensibilisierende Stoffe. Bundesarbeitsbl 12:58–63

    Google Scholar 

  5. Dajani AS, Taubert KA, Wilson W et al. (1997) Prevention of bacterial endocarditis. Recommendations by the American Heart Association. Circulation 96:358–366

    Article  PubMed  CAS  Google Scholar 

  6. Dennis MS, Light DR (1989) Rubber elongation factor from Hevea brasiliensis. Identification, characterization, and role in rubber biosynthesis. J Biol Chem 264:18608–18617

    PubMed  CAS  Google Scholar 

  7. Doenicke A, Soukup J, Hoernecke R, Moss J (1997) The lack of histamine release with cisatracurium: a double-blind comparison with vecuronium. Anesth Analg 84:623–628

    PubMed  CAS  Google Scholar 

  8. ECC Guidelines (2000) Part 6: advanced cardiovascular life support: section 6: pharmacology II: agents to optimize cardiac output and blood pressure.The American Heart Association in collaboration with the International Liaison Committee on Resuscitation. Circulation 102:1291–135

    Google Scholar 

  9. Endoh T, Yagihashi A, Sasaki M, Watanabe N (1999) Ceftizoxime-induced hemolysis due to immune complexes: case report and determination of the epitope responsible for immune complex-mediated hemolysis. Transfusion 39:306–309

    Article  PubMed  CAS  Google Scholar 

  10. Fisher MM (1999) Cisatracurium and atracurium as antigens. Anaesth Intensive Care 27:369–370

    PubMed  CAS  Google Scholar 

  11. Gold M, Swartz JS, Braude BM, Dolovich J, Shandling B, Gilmour RF (1991) Intraoperative anaphylaxis: an association with latex sensitivity. J Allergy Clin Immunol 87:662–666

    Article  PubMed  CAS  Google Scholar 

  12. Hölz W, Ludwig A, Forst H (2002) Anaphylakti-scher Schock nach intravenöser Hydrokortison-succinatgabe. Anaesthesist 51:187–190

    Article  PubMed  Google Scholar 

  13. International Collaborative Study of Severe Anaphylaxis (1998) An epidemiologic study of severe anaphylactic and anaphylactoid reactions among hospital patients: methods and overall risks. Epidemiology 9:141–146

    Article  Google Scholar 

  14. Jekel PA, Hartmann BH, Beintema JJ (1991) The primary structure of hevamine, an enzyme with lysozyme/chitinase activity from Hevea brasiliensis latex. Eur J Biochem 200:123–130

    Article  PubMed  CAS  Google Scholar 

  15. Kelly KJ, Kurup V, Zacharisen M, Resnick A, Fink JN (1993) Skin and serologic testing in the diagnosis of latex allergy. J Allergy Clin Immunol 91:1140–1145

    Article  CAS  Google Scholar 

  16. Kisch H, Jacobs P, Thiel M (1996) Anästhesio-logische Besonderheiten bei Patienten mit Latexallergie. Anaesthesist 45:587–596

    Article  PubMed  CAS  Google Scholar 

  17. Kloeck W, Cummins RO, Chamberlain D et al. (2002) Special resuscitation situations. An advisory statement from the International LiasonCommittee on Resuscitation. Circulation 95:2196–2210

    Article  Google Scholar 

  18. Lavaud F, Prevost A, Cossart C, Guerin L, Bernard J, Kochman S (1995) Allergy to latex, avocado pear, and banana: evidence for a 30 kD antigen in immunoblotting. J Allergy Clin Immunol 95:557–564

    Article  PubMed  CAS  Google Scholar 

  19. Laxenaire MC (1999) Epidemiology of anesthetic anaphylactoid reactions. Fourth multicenter survey (July 1994-December 1996). Ann Fr Anesth Reanim 18:796–809

    Article  CAS  Google Scholar 

  20. Laxenaire MC, Groupe d’Etude des Réactions Anaphylactoides Peranesthésique (1996) Agents causing anaphylactic shock during anesthesia. A third French multicenter study (1992–1994).Ann Fr Anesth Reanim 15:1211–1218

    Article  CAS  Google Scholar 

  21. Laxenaire MC, Mertes PM, Groupe d’Etude des Réactions Anaphylactoides Peranesthésique (2001) Anaphylaxis during anesthesia. Results of a two-year survey in France. Br J Anaesth 87:549–58

    Article  CAS  Google Scholar 

  22. Lee HI, Broekaert WF, Raikhel NV, Lee H (1991) Co- and post-translational processing of the hevein preproprotein of latex of the rubber tree (Hevea brasiliensis) J Biol Chem 266:15944–15948

    PubMed  CAS  Google Scholar 

  23. Liebermann P (1990) The use of antihistamines in the prevention and treatment of anaphylaxis and anaphylactic reactions. J Allergy Clin Immunol 86:684–686

    Article  Google Scholar 

  24. Light DR, Dennis MS (1989) Purification of a prenyltransferase that elongates cis-polyiso-prene rubber from the latex of Hevea brasiliensis. J Biol Chem 264:18589–18597

    PubMed  CAS  Google Scholar 

  25. Liss GM, Sussman GL (1999) Latex sensitization: occupational versus general population prevalence rates. Am J Ind Med 35:196–200

    Article  PubMed  CAS  Google Scholar 

  26. Ljungstrom KG (1983) Prophylaxis of postoperative thromboembolism with dextran 70: improvements of efficacy and safety. Acta ChirScand SuppI 514:1–40

    CAS  Google Scholar 

  27. Lorenz W, Ennis M, Doenicke A, Dick W (1990) Perioperative uses of histamine antagonists. J Clin Anaesth 2:345–360

    Article  CAS  Google Scholar 

  28. McHale SP, Konieczko K (1992) Anaphylactoid reaction to propofol. Anaesthesia 47:864–865

    Article  PubMed  CAS  Google Scholar 

  29. Millbern SM, Bell SD (1979) Prevention of anaphylaxis to contrast medium. Anesthesiology 50:56–57

    Article  PubMed  CAS  Google Scholar 

  30. Miranda A, Bianca M, Vega JM et al. (1996) Cross-reactivity between a penicillin and a cephalosporin with the same side chain. J Allergy Clin Immunol 98:671–677

    Article  PubMed  CAS  Google Scholar 

  31. Müller-Werdan U, Werdan K (1997) Deranphy-laktische Schock. Anaesthesist 46:549–563

    Article  PubMed  Google Scholar 

  32. Müller-Werdan U, Werdan K (2000) Anaphylaxie und Allergie. Empfehlungen für die Notfalltherapie. [Anaphylaxis and allergy. Recommendations for emergency treatment]. Internist (Berl) 41:363–373

    Article  Google Scholar 

  33. Palosuo T, Makinen KS, Alenius H, Reunala T, Yip E, Turjanmaa K (1998) Measurement of natural rubber latex allergen levels in medical gloves by allergen-specific IgE-ELISA inhibition, RAST inhibition, and skin prick test. Allergy 53:59–67

    Article  PubMed  CAS  Google Scholar 

  34. Porri F, Pradal M, Lemiere C et al. (1997) Association between latex sensitization and repeated latex exposure in children. Anesthesiology 86:599–602

    Article  PubMed  CAS  Google Scholar 

  35. Project Team of the Resuscitation Council (UK) (1999) Emergency medical treatment of anaphylactic reactions. J Accid Emerg Med 16:243–247

    Article  Google Scholar 

  36. Ring J, Messmer K (1977) Incidence and severity of anaphylactoid reactions to colloid volume substitutes. Lancet 27:466–469

    Article  Google Scholar 

  37. Rueff F, Przybilla B (1997) Prevention of natural latex allergy. Prävention der Naturlatexallergie. Fortschr Fortbild Med 21:295–301

    Google Scholar 

  38. Rueff F, Thomas P, Reissig G, Przybilla B (1998) Natural rubber-latex allergy in patients not intensely exposed. Allergy 53:445–449

    Article  PubMed  CAS  Google Scholar 

  39. Sastre J, Quijano LD, Novalbos A et al. (1996) Clinical cross-reactivity between amoxicillin and cephadroxil in patients allergic to amoxicillin and with good tolerance of penicillin. Allergy 51:383–386

    PubMed  CAS  Google Scholar 

  40. Schindera I (1999) Naturlatexallergie. Die verdrängte Berufskrankheit. Dtsch Arztebl 96:B-2407–B-2408

    Google Scholar 

  41. Sedman AJ (1984) Cimetidin-drug interactions. Am J Med 76:109–114

    Article  PubMed  CAS  Google Scholar 

  42. Shuto H, Sueyasu M, Otsuki S, Hara T, Tsuruta Y, Kataoka Y, Oishi R (1999) Potentiation of vancomycin-induced histamine release by muscle relaxants and morphine in rats. Antimicrob Agents Chemother 43:2881–2884

    PubMed  CAS  Google Scholar 

  43. Simons FE, Roberts JR, Gu X, Simons KJ (1998) Epinephrine absorption in children with a history of anaphylaxis. J Allergy Clin Immunol 101:33–37

    Article  PubMed  CAS  Google Scholar 

  44. Steinberg EP, Moore RD, Powe NR et al. (1992) Safety and cost effectiveness of high-osmola-lity as compared with low-osmolality contrast material in patients undergoing cardiac angiography. N Engl J Med 326:425–430

    Article  PubMed  CAS  Google Scholar 

  45. Stellato C, Casolaro V, Ciccarelli A, Mastronardi P, Mazzarella B, Marone G (1991) General anaesthetics induce only histamine release selectively from human mast cells. BrJ Anaesth 67:751–758

    Article  Google Scholar 

  46. Vogel F, Naber KG, Wacha H, Shah P, Sörgel F, Kayser FH, Maschmeyer G, Lode H, Expertengruppe der Paul-Ehrlich-Gesellschaft für Chemotherapie e.V. (1999) Parenterale Antibiotika bei Erwachsenen. Chemother J 8:2–49

    Google Scholar 

  47. Waldhausen E (1998) Der anaphylaktische Schock. Anaesthesist 47:549–563

    Article  Google Scholar 

  48. Young MF, McConville JP (2000) Anaphylactoid reaction to methylprenisolone. Is it surprising when pharmacological and immune effects of a drug differ? [letter]. J Neurol Neurosurg Psychiatry 68:255–256

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Klinik für Anästhesiologie, Klinikum Großhadern, München, Deutschland

    Dr. med. Hille Kisch-Wedel & M. Thiel

  2. Klinik für Anästhesiologie, Klinikum Großhadern, Marchioninistr. 27, 81377, München, Deutschland

    Dr. med. Hille Kisch-Wedel

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  1. Dr. med. Hille Kisch-Wedel
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  2. M. Thiel
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Editor information

Editors and Affiliations

  1. Klinik für Anästhesiologie, Universität Heidelberg, Im Neuenheimer Feld 110, D-69120, Heidelberg, Deutschland

    Hubert J. Bardenheuer

  2. Klinik für Anästhesiologie und operative Intensivmedizin Zentralklinikum, Stenglinstraße 2, D-86156, Augsburg, Deutschland

    Helmuth Forst

  3. Klinik für Anästhesiologie, Medizinische Einrichtungen der RWTH Aachen, Pauwelsstraße 30, D-52074, Aachen, Deutschland

    Rolf Rossaint

  4. Service d’Anesthésiologie Centre Hospitalier, Universitaire Vaudois - CHUV, Rue du Bugnon 46, CH-1011, Lausanne, Schweiz

    Donat R. Spahn

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Kisch-Wedel, H., Thiel, M. (2003). Anästhesie bei allergischer Diathese. In: Bardenheuer, H.J., Forst, H., Rossaint, R., Spahn, D.R. (eds) Weiterbildung für Anästhesisten 2002. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-10888-8_10

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  • DOI: https://doi.org/10.1007/978-3-662-10888-8_10

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-00092-1

  • Online ISBN: 978-3-662-10888-8

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