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Perioperative Anaphylaxis

  • Anaphylaxis (M Sanchez-Borges, Section Editor)
  • Published:
Current Treatment Options in Allergy Aims and scope Submit manuscript

Abstract

Purpose of the review

Perioperative anaphylaxis is a severe, systemic hypersensitivity reaction of rapid onset, that is generally unpredictable, may be life-threatening, and occurs after the use of different drugs, substances, or stimuli during an anesthetic or surgical procedure.

Recent findings

The potential causes of reactions during procedures depend on the moment it occurs. In the induction phase, neuromuscular blockers, intravenous antibiotics, and opioids should be considered. During the procedure, along with antibiotics and opioids, other causes include local anesthetics, nonsteroidal anti-inflammatory agents (NSAIDs), contrast media, clorhexidin, and latex. In the recovery phase, the most common agents are latex and medications which reverse anesthesia effects. Recently, sugammadex has been discovered to be an important causal agent.

Summary

Early onset of treatment is essential in anaphylaxis and could prevent complications or death. The management is the same in all ages following the accepted protocols for the management of anaphylaxis. Adrenaline is the treatment of choice. A complete review of the clinical and perioperative history is essential before any procedure in patients with prior anaphylaxis. It is recommended that surgeons and anesthesiologists communicate each other their concerns and ask the allergist if there is a doubt about an allergic reaction.

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Author information

Authors and Affiliations

  1. Regional Center of Allergy and Clinical Immunology, University Hospital “Dr. José Eleuterio González”, Monterrey, Nuevo León, Mexico

    Sandra Nora Gonzalez-Diaz MD PhD, Cindy Elizabeth de Lira-Quezada MD, Rosalaura Virginia Villarreal-Gonzalez MD, Rosa Ivett Guzman-Avilan MD, Carlos Macouzet-Sanchez MD & Gabriela Galindo-Rodriguez MD PhD

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  1. Sandra Nora Gonzalez-Diaz MD PhD
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  2. Cindy Elizabeth de Lira-Quezada MD
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  3. Rosalaura Virginia Villarreal-Gonzalez MD
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  6. Gabriela Galindo-Rodriguez MD PhD
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Correspondence to Sandra Nora Gonzalez-Diaz MD PhD.

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Conflict of interest

Sandra Nora González-Díaz, Cindy Elizabeth de Lira-Quezada, Rosalaura Virginia Villarreal-González, Rosa Ivett Guzmán-Avilán, Carlos Macouzet-Sanchez and Gabriela Galindo Rodríguez declare no conflicts of interest relevant to this manuscript.

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This article is part of the Topical Collection on Anaphylaxis

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Gonzalez-Diaz, S.N., de Lira-Quezada, C.E., Villarreal-Gonzalez, R.V. et al. Perioperative Anaphylaxis. Curr Treat Options Allergy 7, 198–210 (2020). https://doi.org/10.1007/s40521-020-00250-2

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