Division of Allergic Diseases, Department of Medicine, Mayo Medical School, Mayo Clinic, Rochester, Minn.
Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.
J Allergy Clin Immunol Pract. 2019 Sep-Oct;7(7):2134-2142. doi: 10.1016/j.jaip.2019.05.033. Epub 2019 May 31.
The authors present a case of a patient with multiple episodes of perioperative anaphylaxis. The incidence and the most common causes of perioperative anaphylaxis are reviewed. The most common causes can vary by country and the type of perioperative medications used. The unique environment and the multiple medications and substances used in the anesthesia and surgical setting that make a definitive diagnosis challenging are outlined. A systematic strategy to recognize the reaction, identify the culprit, and direct future management are demonstrated. Management of the patient experiencing perioperative anaphylaxis requires close collaboration between the anesthesia, surgical, and allergy teams.
作者报告了一例多次围手术期过敏反应的患者。文中回顾了围手术期过敏反应的发生率和最常见的原因。最常见的原因可能因国家和围手术期使用的药物类型而异。文中概述了麻醉和外科环境的独特环境以及使用的多种药物和物质使明确诊断具有挑战性。文中还展示了一种识别反应、确定罪魁祸首并指导未来管理的系统策略。围手术期过敏反应患者的管理需要麻醉、外科和过敏团队之间的密切合作。
