Department of Immunology and Allergy, Children's Hospital at Westmead, Locked Bag 4001, Westmead, 2145, Australia.
Anesth Analg. 2011 Jul;113(1):140-4. doi: 10.1213/ANE.0b013e31821b450f. Epub 2011 Apr 5.
Egg and/or soy allergy are often cited as contraindications to propofol administration. Our aim was to determine whether children with an immunoglobulin (Ig)E-mediated egg and/or soy allergy had an allergic reaction after propofol use.
We performed a retrospective case review over an 11-year period (1999-2010) of children with IgE-mediated egg and/or soy allergy who had propofol administered to them at the Children's Hospital Westmead, Sydney.
Twenty-eight egg-allergic patients with 43 propofol administrations were identified. No child with a soy allergy who had propofol was identified. Twenty-one children (75%) were male, the median age at anesthesia was 2.4 years (range, 1-15 years), and the presence of other atopic disease was common (eczema 61%, asthma 32%, peanut allergy 43%). Most children (n = 19, 68%) had a history of an IgE-mediated clinical reaction to egg with evidence of a significantly positive egg white skin prick test (SPT) reaction (≥7 mm). Two of these had a history of egg anaphylaxis. The remaining children (n = 9, 32%) had never ingested egg because of significantly positive SPT (≥7 mm). All SPTs to egg were performed within 12 months of propofol administration. There was one nonanaphylactic immediate allergic reaction (n = 1 of 43, 2%) that occurred 15 minutes after propofol administration in a 7-year-old boy with a history of egg anaphylaxis and multiple other IgE-mediated food allergies (cow's milk, nut, and sesame). SPT to propofol was positive at 3 mm. No other egg-allergic child reacted to propofol.
Despite current Australian labeling warnings, propofol was frequently administered to egg-allergic children. Propofol is likely to be safe in the majority of egg-allergic children who do not have a history of egg anaphylaxis.
鸡蛋和/或大豆过敏常被认为是丙泊酚给药的禁忌症。我们的目的是确定是否有免疫球蛋白（IgE）介导的鸡蛋和/或大豆过敏的儿童在使用丙泊酚后会发生过敏反应。
我们对西悉尼儿童医院（1999-2010 年）期间进行了一项回顾性病例回顾研究，研究对象为 IgE 介导的鸡蛋和/或大豆过敏的儿童，这些儿童在该院接受了丙泊酚治疗。
确定了 28 名鸡蛋过敏患儿，共进行了 43 次丙泊酚给药。未发现大豆过敏且接受丙泊酚治疗的患儿。21 名患儿（75%）为男性，麻醉时的中位年龄为 2.4 岁（1-15 岁），常见其他特应性疾病（湿疹 61%、哮喘 32%、花生过敏 43%）。大多数患儿（n=19，68%）有 IgE 介导的鸡蛋过敏临床反应史，且有明显阳性的蛋清皮试（SPT）反应（≥7mm）。其中 2 例有鸡蛋过敏史。其余患儿（n=9，32%）从未因 SPT（≥7mm）阳性而摄入过鸡蛋。所有鸡蛋 SPT 均在丙泊酚给药前 12 个月内进行。在一名 7 岁男孩中发生了 1 例非过敏性即刻过敏反应（n=43，2%），该男孩有鸡蛋过敏史和多种其他 IgE 介导的食物过敏史（牛奶、坚果和芝麻），在丙泊酚给药后 15 分钟发生。该患儿的丙泊酚 SPT 为阳性，为 3mm。没有其他鸡蛋过敏的患儿对丙泊酚有反应。
尽管目前澳大利亚有标签警告，但丙泊酚经常被用于鸡蛋过敏的儿童。在没有鸡蛋过敏史的大多数鸡蛋过敏儿童中，丙泊酚可能是安全的。
