INSERM U 911, Groupe Choc, Hôpital Central, Nancy, France.
Minerva Anestesiol. 2012 Aug;78(8):868-78. Epub 2012 Mar 22.
Hypersensitivity reactions occurring during anesthesia remain a major cause of concern for anesthesiologists. We report the results of the ninth consecutive survey of hypersensitivity reactions observed during anesthesia in France. This report will be used as an epidemiologic reference prior to this intervention.
Between January 1, 2005 to December 31, 2007, 1253 patients who experienced an immune-mediated (IgE-mediated) or non-immune-mediated (non-IgE-mediated) hypersensitivity reaction were referred to one of the 40 participating centers. Diagnosis was established on the basis of clinical history, skin tests and/or specific IgE assay.
An IgE-mediated or non-IgE-mediated reaction was diagnosed in 786 cases (63%) and 467 cases (37%), respectively. The most common causes of anaphylaxis were neuromuscular blocking agents (NMBA) (N.=373, 47.4%), latex (N.=158, 20%), and antibiotics (N.=141, 18.1%). Succinylcholine (N.=226, 60.6%) was the most frequently incriminated NMBA, whereas the low frequency of reactions involving cis-atracurium was confirmed (N.=22, 5.9%) when market shares of each NMBA were taken into account. An increased number of reactions involving vital dyes was recorded (N.=34, 4.4%).
These changes in the epidemiology of allergic reactions confirm the need for regular epidemiologic surveys of anaphylaxis in the perioperative period.
麻醉期间发生的过敏反应仍然是麻醉师关注的主要问题。我们报告了法国连续第九次麻醉期间观察到的过敏反应调查结果。在进行此干预之前，该报告将作为流行病学参考。
2005 年 1 月 1 日至 2007 年 12 月 31 日期间，1253 例发生免疫介导（IgE 介导）或非免疫介导（非 IgE 介导）过敏反应的患者被转介至 40 个参与中心之一。诊断是基于临床病史、皮肤试验和/或特异性 IgE 测定。
诊断为 IgE 介导或非 IgE 介导反应的分别为 786 例（63%）和 467 例（37%）。过敏反应最常见的原因是神经肌肉阻滞剂（NMBA）（N=373，47.4%）、乳胶（N=158，20%）和抗生素（N=141，18.1%）。琥珀酰胆碱（N=226，60.6%）是最常被怀疑的 NMBA，而当考虑到每种 NMBA 的市场份额时，证实了涉及顺式阿曲库铵的反应频率较低（N=22，5.9%）。记录到涉及生命染料的反应数量增加（N=34，4.4%）。
这些过敏反应流行病学的变化证实了在围手术期定期进行过敏反应流行病学调查的必要性。
