Department of Pediatrics, University of Parma, Parma, Italy.
Int J Immunopathol Pharmacol. 2011 Jul-Sep;24(3 Suppl):S91-9. doi: 10.1177/03946320110240s313.
Hypersensitivity reactions during perioperative period are increasing and may be potentially life-threatening. Therefore, major emphasis is given to prevention. We perform a review to examine which measures should be taken to prevent reactions to products used in elective and emergency surgery. Any patient with a history of previous anaphylaxis or severe reaction during anaesthesia should be referred to allergist for detection of the offending compound. However, the identification of the triggering agent is not always feasible because of the low accuracy of diagnostic tests. In these cases and when emergency surgery is required, it should be considered to replace all drugs administered before the onset of the reaction with alternatives. Furthermore, any cross-reacting agent and latex, especially in patients belonging to populations at-risk for latex allergy should be avoided. In susceptible patients, premedication with antihistamines and corticosteroids might reduce the severity of reaction to drugs or contrast material while it is unclear whether pre-treatment decreases incidence of anaphylactic reactions. There is no evidence that premedication prevents allergic reactions to latex. Overall, physicians should not rely on the efficacy of premedication.
围手术期过敏反应日益增多，且可能危及生命。因此，重点在于预防。我们进行了一项综述，以探讨应采取哪些措施来预防择期和急诊手术中使用的产品发生过敏反应。任何有既往过敏史或麻醉期间发生严重过敏反应的患者，都应转介给过敏专家以确定致敏化合物。然而，由于诊断检测的准确性较低，并非总能确定触发剂。在这些情况下，并且需要紧急手术时，应考虑用替代品替换在反应发生前给予的所有药物。此外，应避免使用任何交叉反应性药物和乳胶，尤其是乳胶过敏高危人群的患者。在易感患者中，术前使用抗组胺药和皮质类固醇可能会减轻对药物或对比剂的反应严重程度，但尚不清楚预处理是否会降低过敏反应的发生率。没有证据表明预处理可预防乳胶过敏反应。总体而言，医生不应依赖于术前用药的疗效。
