Nabatame Maki, Mori Masanobu, Ikeda Yoshikazu, Matsushita Mitsuji, Tsujimura Shigehisa
Department of Anesthesiology, Hoshigaoka Koseinenkin Hospital, Hirakata 108-8616.
Masui. 2010 Feb;59(2):252-6.
Anaphylaxis is an acute life-threatening systematic reaction, and it requires early diagnosis and correct management to save the patients. The true incidence of anaphylaxis during general anesthesia is unknown. Although anaphylaxis is a rare intraoperative complication, most drugs used in the perioperative period can lead to anaphylaxis.
All patients who had received operations under general anesthesia in our hospital were covered in this study during the 5-year period. We searched for the incidence and clinical features of anaphylaxis retrospectively.
Seven cases in 9,844 patients were recognized. Various drugs were suspected as causal agents, but they were all nonanesthesia related drugs. The diagnosis of anaphylaxis relied on the history and clinical course of each patient. There was no reliable diagnostic testing such as serum tryptase and skin test. So we could not determine whether the reaction was IgE-mediated or not.
Immediate discontinuation of causal drugs and early administration of epinephrine are cornerstones of treatment. More specific diagnostic tests are required for correct identification of causal drugs. To reduce the risk of anaphylaxis during anesthesia, we hope practical data bases and guidelines for anaphylaxis related to anesthesia will be published in the future.
过敏反应是一种危及生命的急性全身性反应，需要早期诊断和正确处理以挽救患者生命。全身麻醉期间过敏反应的真实发生率尚不清楚。尽管过敏反应是一种罕见的术中并发症，但围手术期使用的大多数药物都可能导致过敏反应。
本研究涵盖了我院5年间所有接受全身麻醉手术的患者。我们回顾性地查找过敏反应的发生率和临床特征。
在9844例患者中识别出7例。多种药物被怀疑为病因，但均为非麻醉相关药物。过敏反应的诊断依赖于每位患者的病史和临床病程。没有血清类胰蛋白酶和皮肤试验等可靠的诊断检测方法。因此我们无法确定该反应是否由IgE介导。
立即停用致病药物并早期给予肾上腺素是治疗的基石。需要更特异的诊断检测方法来正确识别致病药物。为降低麻醉期间过敏反应的风险，我们希望未来能发布与麻醉相关的过敏反应实用数据库和指南。
