Anaphylaxis during general anaesthesia: experience from a drug allergy centre in the UK

Acta Anaesthesiol Scand. 2017 Mar;61(3):281-289. doi: 10.1111/aas.12858.

Abstract

Background: Anaphylaxis during general anaesthesia is rare but often severe. Identification of the cause of anaphylaxis and recommendation of a range of drugs or agents likely to be safer for future surgery is a collaborative venture between the allergists and the anaesthesiologists, but it often poses a significant challenge.

Methods: A total of 31 patients who attended the Drug Allergy Unit at University College London Hospital with suspected perioperative anaphylaxis between March 2013 and January 2016 were reviewed retrospectively.

Results: The culprit drug was identified in 21 patients (67.7%): antibiotics (n = 11, 52.3%), neuromuscular blocking agents (n = 8, 38.1%), morphine (n = 1, 4.8%) and gelofusine (n = 1, 4.8%). No cause was identified in six patients (19.4%), and four patients (12.9%) had non-allergic reactions.

Conclusion: Our results confirm that antibiotics and neuromuscular blocking agents are common causative agents of perioperative anaphylaxis in the United Kingdom.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anaphylaxis / etiology*
  • Anesthesia, General / adverse effects*
  • Anti-Bacterial Agents / adverse effects
  • Drug Hypersensitivity / etiology*
  • Female
  • Humans
  • Latex Hypersensitivity / complications
  • Male
  • Middle Aged
  • Neuromuscular Blocking Agents / adverse effects
  • Retrospective Studies
  • Skin Tests

Substances

  • Anti-Bacterial Agents
  • Neuromuscular Blocking Agents