Velicković Jelena, Ladjević Nebojsa, Milaković Branko, Likić-Ladjević Ivana, Ugrinović Djordje, Kalezić Nevena
Center for Anesthesia, Clinical Center of Serbia, Belgrade, Serbia.
Acta Chir Iugosl. 2011;58(2):177-83. doi: 10.2298/aci1102177v.
The prevalence of allergic reactions in general opulation shows a constant rise. It has been estimated that up to 40% of surgical patients have a positive history of some kind of allergy. These patients represent a challenge during perioperative evaluation, since they can be exposed to a large variety of drugs and substances during surgery and anesthesia. A lot of adverse drug reactions show similar clinical presentation with allergic reactions. The latter are usually poorly explored since preoperative allergology testing is performed in a limited number of patients. Management of patients with history of allergy is impeded by the fact that most of allergens cross-react in a manner that is not always easy to predict. Allergies can manifest themselves with a broad spectrum of clinical symptoms, ranging from mild skin symptoms such as itch and urticaria, to a life-threatening anaphylactic reactions followed by hypotension, bronchospasm and cardiovascular collapse. Prevention of allergic reactions during perioperative period requires detailed history taking in order to identify patients at risk, optimization of anesthesia strategy, pharmacological premedication and further allergology diagnostic work-up in selected cases.
普通人群中过敏反应的患病率呈持续上升趋势。据估计，高达40%的外科手术患者有某种过敏史。这些患者在围手术期评估期间是一个挑战，因为他们在手术和麻醉期间可能接触到各种各样的药物和物质。许多药物不良反应与过敏反应表现出相似的临床症状。由于术前过敏测试仅在少数患者中进行，后者通常未得到充分探究。过敏史患者的管理受到阻碍，因为大多数过敏原会以一种难以预测的方式发生交叉反应。过敏反应可表现为广泛的临床症状，从轻微的皮肤症状如瘙痒和荨麻疹，到危及生命的过敏反应，随后出现低血压、支气管痉挛和心血管衰竭。围手术期预防过敏反应需要详细询问病史以识别高危患者，优化麻醉策略，进行药理学术前用药，并在特定病例中进一步开展过敏诊断检查。
