Lorenz W, Ennis M, Doenicke A, Dick W
Institute for Theoretical Surgery, University of Marburg, FRG.
J Clin Anesth. 1990 Sep-Oct;2(5):345-60. doi: 10.1016/0952-8180(90)90083-f.
Histamine release and adverse pseudoallergic/allergic reactions during the perioperative period occur frequently. The incidence of such reactions is 20%-30% for all grades of severity, 1%-5% for systemic reactions, and 0.1%-0.5% for life-threatening reactions. They can be elicited by all commonly used anesthetic agents and by surgical interventions. Both the incidence and severity can be reduced by the use of combined prophylaxis with H1- + H2-receptor antagonists. The authors recommend that this prophylaxis be given to the following groups of patients: those with a history of adverse reactions or history of allergy, patients undergoing surgery with a high risk of histamine release, elderly patients, and those with poor physical status due to underlying systemic diseases. These indications have been developed by heuristic medical decision-making, including a decision tree.
围手术期组胺释放及不良类过敏/过敏反应频繁发生。所有严重程度等级的此类反应发生率为20% - 30%，全身反应发生率为1% - 5%，危及生命反应的发生率为0.1% - 0.5%。所有常用麻醉剂及外科手术干预均可引发这些反应。联合使用H1 + H2受体拮抗剂进行预防可降低发生率及严重程度。作者建议对以下几组患者进行这种预防：有不良反应史或过敏史者、组胺释放风险高的手术患者、老年患者以及因潜在全身性疾病而身体状况较差者。这些适应证是通过启发式医学决策制定的，包括决策树。
