| Title: | Anaesthetic management of patients with pre-existing allergic conditions : a narrative review |
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| Authors: | ID Dewachter, Pascale (Author)
ID Kopač, Peter, Klinika Golnik (Author)
ID Laguna, Jose Julio (Author)
ID Mertes, Paul Michel (Author)
ID Sabato, Vito (Author)
ID Volcheck, Gerald W. (Author)
ID Cooke, Peter J. (Author) |
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| Files: |  URL - Source URL, visit https://bjanaesthesia.org/article/S0007-0912(19)30060-1/fulltext
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| Language: | English |
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| Typology: | 1.02 - Review Article |
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| Organization: |  UKPBAG - University Clinic of Respiratory and Allergic Diseases Golnik
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| 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. |
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| Keywords: | allergy and immunology, drug hypersensitivity, food hypersensitivity, immediate hypersensitivity, anaphylaxis, anesthesia, drug-related side effects and adverse reactions, perioperative period, adverse effects |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Place of publishing: | Velika Britanija |
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| Publisher: | Elsevier |
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| Year of publishing: | 2019 |
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| Number of pages: | str. e65-e81 |
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| Numbering: | Vol. 123, iss. 1 |
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| PID: | 20.500.12556/DiRROS-12586  |
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| UDC: | 616-097 |
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| ISSN on article: | 1471-6771 |
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| DOI: | 10.1016/j.bja.2019.01.020 |
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| COBISS.SI-ID: | 2048508785 |
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| Copyright: | © 2019 British Journal of Anaesthesia |
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| Note: | Soavtor iz Slovenije: Peter Kopac;
Nasl. z nasl. zaslona;
Opis vira z dne 3. 6. 2019;
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| Publication date in DiRROS: | 16.10.2020 |
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| Views: | 1801 |
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| Downloads: | 626 |
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