ǂa ǂnarrative review
Pascale Dewachter (Author), Peter Kopač (Author), Jose Julio Laguna (Author), Paul Michel Mertes (Author), V. Sabato (Author), Gerald W. Volcheck (Author), Peter J. Cooke (Author)

Abstract

This narrative review seeks to distinguish the clinical patterns of pre-existing allergic conditions from other confounding non-allergic clinical entities, and to identify the potential related risks and facilitate their perioperative management. Follow-up investigation should be performed after a perioperative immediate hypersensitivity to establish a diagnosis and provide advice for subsequent anaesthetics, the main risk factor for perioperative immunoglobulin E (IgE)-mediated anaphylaxis being a previous uninvestigated perioperative immediate hypersensitivity reaction. The concept of cross-reactivity between drugs used in the perioperative setting and food is often quoted, but usually not supported by evidence. There is no reason to avoid propofol in egg, soy, or peanut allergy. The allergenic determinants have been characterised for fish, shellfish, and povidone iodine, but remain unknown for iodinated contrast agents. Iodinated drugs may be used in seafood allergy. Evidence supporting the risk for protamine allergy in fish allergy and in neutral protamine Hagedorn insulin use is lacking. Conversely, cross-reactivity to gelatin-based colloid may occur in agal syndrome. Atopy and allergic asthma along with other non-allergic conditions, such as NSAID-exacerbated respiratory disease, chronic urticaria, mastocytosis, and hereditary or acquired angioedema, are not risk factors for IgEmediated drug allergy, but there is a perioperative risk associated with the potential for exacerbation of the various conditions.

Keywords

neželeni učinki;adverse effects;

Data

Language: English
Year of publishing:
Typology: 1.02 - Review Article
Publisher: Elsevier
UDC: 616-097
COBISS: 2048508785 Link will open in a new window
ISSN: 1471-6771
Parent publication: British journal of anaesthesia
Views: 856
Downloads: 322
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Other data

Secondary keywords: Allergy and immunology;Drug hypersensitivity;Food hypersensitivity;Hypersensitivity, immediate;Anaphylaxis;Anesthesia;Drug-related side effects and adverse reactions;Perioperative period;Alergija in imunologija;Preobčutljivost za zdravila;Preobčutljivost za hrano;Takojšnja preobčutljivost;Anafilaksija;Anestezija;Stranski in škodljivi učinki zdravil;Perioperativno obdobje;
Source comment: Soavtor iz Slovenije: Peter Kopac; Nasl. z nasl. zaslona; Opis vira z dne 3. 6. 2019;
Pages: str. e65-e81
Volume: ǂVol. ǂ123
Issue: ǂiss. ǂ1
Chronology: Jul. 2019
DOI: 10.1016/j.bja.2019.01.020
ID: 12080811