University of California, Davis, Sacramento, CA 95817, USA.
J Anesth. 2013 Aug;27(4):588-98. doi: 10.1007/s00540-013-1563-2. Epub 2013 Feb 14.
Mastocytosis is an orphan disease rarely encountered by practicing anesthesiologists. Children with mastocytosis often present for procedures or surgery requiring anesthesia. Because many of the medications commonly used in pediatric anesthesia have been reported to initiate mast cell activation, parents are often very anxious about their child's perioperative experience. Laboratory investigations of serum histamine assays associated with different anesthetic drugs have not been shown to predict mast cell degranulation in these patients. However, the pediatric literature suggests that children with disease limited to the skin rarely suffer serious side effects from anesthesia, and there are no reported fatalities. Preoperative prophylaxis is usually based on expert opinion and case reports. Detailed tables summarizing reports of anesthetic medications used for children with mastocytosis undergoing anesthesia, reported side effects, and suggested prophylaxis regimens are included in this review.
肥大细胞增多症是一种罕见的孤儿病，执业麻醉师很少遇到。患有肥大细胞增多症的儿童经常因需要麻醉的手术或程序而就诊。由于许多常用于小儿麻醉的药物已被报道会引发肥大细胞活化，因此家长通常对孩子的围手术期体验非常焦虑。与不同麻醉药物相关的血清组胺测定的实验室研究并未表明可以预测这些患者的肥大细胞脱颗粒。然而，儿科文献表明，疾病局限于皮肤的儿童很少因麻醉而遭受严重的副作用，也没有报告死亡病例。术前预防通常基于专家意见和病例报告。本综述包括了总结用于接受麻醉的肥大细胞增多症儿童的麻醉药物、报告的副作用以及建议的预防方案的详细表格。
