Lapisatepun Worawut, Charuluxananan Somrat, Kusumaphanyo Chaiyapruk, Ittichaikulthol Wichai, Suksompong Sirilak, Ratanachai Prapa
Department of Anesthesiology, Chiang Mai University, Chiang Mai, Thailand.
J Med Assoc Thai. 2008 Oct;91(10):1524-30.
Analyze the clinical course, management, outcome, and contributing factors of perioperative allergic reactions in the Thai Anesthesia Incident Monitoring Study (Thai AIMS).
A prospective descriptive multicenter study was conducted in 51 hospitals across Thailand Voluntary, anonymous reports of any adverse or undesirable events during the first 24 hours of anesthesia were sent to the Thai AIMS data management unit. Possible perioperative allergic reactions were extracted and examined independently by three peer reviewers.
Forty-three reports of possible perioperative allergic reactions from the 2,537 incidents reported to the Thai AIMS (1.6%) were reviewed. There was a female predominance (1.9:1). The most common features were cutaneous manifestations (93%), arterial hypotension (20.1%), and bronchospasm (11.6%) respectively. The severity grades were 69.8% in grade I, 4.7% in grade II, and 25.6% in grade III. The three most suspected causative agents were neuromuscular blocking agents (39.5%, 30.2%-succinylcholine), antibiotics (27.9%), and opioids (18.6%) respectively. All but one responded well to treatment with complete recovery. One patient suffered acute myocardial infarction and had to stay at the hospital for longer than one week. None had further allergic reaction.
Perioperative allergic reactions accounted for 1.6% of anesthetic adverse events. The most common features were cutaneous manifestations. A quarter of these were life-threatening but responded well to treatment. The most common suspected causative agent was succinylcholine.
在泰国麻醉事件监测研究（Thai AIMS）中分析围手术期过敏反应的临床过程、管理、结局及相关因素。
在泰国各地的51家医院开展了一项前瞻性描述性多中心研究。麻醉开始后24小时内发生的任何不良或意外事件的自愿、匿名报告被发送至泰国麻醉事件监测研究数据管理部门。可能的围手术期过敏反应由三名同行评审员独立提取并检查。
对向泰国麻醉事件监测研究报告的2537起事件中的43份可能的围手术期过敏反应报告（1.6%）进行了审查。女性占多数（1.9:1）。最常见的特征分别为皮肤表现（93%）、动脉低血压（20.1%）和支气管痉挛（11.6%）。严重程度分级为：I级占69.8%，II级占4.7%，III级占25.6%。三种最可疑的致病因素分别为神经肌肉阻滞剂（39.5%，其中琥珀酰胆碱占30.2%）、抗生素（27.9%）和阿片类药物（18.6%）。除1例患者外，其他患者经治疗后反应良好且完全康复。1例患者发生急性心肌梗死，需住院超过1周。无一例患者出现进一步过敏反应。
围手术期过敏反应占麻醉不良事件的1.6%。最常见的特征是皮肤表现。其中四分之一为危及生命的情况，但对治疗反应良好。最常见的可疑致病因素是琥珀酰胆碱。
