Siemiatkowski Andrzej, Kościuczuk Urszula
Klinika Anestezjologii i Intensywnej Terapii, Uniwersytet Medyczny w Białymstoku.
Anestezjol Intens Ter. 2010 Jan-Mar;42(1):31-6.
The incidence of allergic reactions during anaesthesia has been estimated to be from 1:3500 to 1:20000, with muscle relaxants being the most common allergens. Symptoms may involve all organs and systems with various intensities--from mild skin reactions to bronchospasm and cardiovascular collapse in the most severe cases. In a case of suspected perioperative allergic reaction, the management should not be limited to resuscitation and restoration of basic life functions, but must include careful investigation of potential allergens. An appropriate diagnostic strategy is essential for confirmation of an allergic reaction, identification of the allergen, and recommendations for future prevention. In this review, the various aspects of anaphylaxis and anaphylactoid reactions to muscle relaxants are discussed, including the role of tryptase and its assay in the diagnostic regimen.
据估计,麻醉期间过敏反应的发生率为1:3500至1:20000,其中肌肉松弛剂是最常见的过敏原。症状可能累及所有器官和系统,程度各异——从轻微的皮肤反应到最严重情况下的支气管痉挛和心血管衰竭。对于疑似围手术期过敏反应的病例,处理不应局限于复苏和恢复基本生命功能,还必须包括对潜在过敏原的仔细调查。适当的诊断策略对于确认过敏反应、识别过敏原以及提出未来预防建议至关重要。在本综述中,将讨论对肌肉松弛剂的过敏反应和类过敏反应的各个方面,包括类胰蛋白酶在诊断方案中的作用及其检测方法。