Anaesthetic Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Danish Anaesthesia Allergy Centre, Allergy Clinic, Department of Dermatology and Allergy, Gentofte Hospital.
Curr Opin Anaesthesiol. 2020 Jun;33(3):448-453. doi: 10.1097/ACO.0000000000000857.
Perioperative hypersensitivity reactions can pose diagnostic and management challenges for the anaesthetist. Difficulties in diagnosing hypersensitivity reactions in the perioperative setting are highlighted and recommendations from recent guidelines on the acute management of life-threatening anaphylaxis are presented.
Anaesthetists play a key role in investigating perioperative hypersensitivity reactions. During a suspected perioperative hypersensitivity event, a serum tryptase level should be measured to help with subsequent allergy investigation. Moreover, anaesthetists can ensure that a high-quality referral is made to allergy clinics by providing thorough documentation of the events, detailing symptoms, treatments, and the chronology of drug administrations.
Perioperative hypersensitivity reactions are rare but can be life-threatening. A high index of suspicion should be maintained for their successful management. Whenever a perioperative hypersensitivity reaction is suspected, close collaboration between anaesthetist and the allergy team investigating the patient is paramount, in order for the patient to be appropriately investigated and have an uneventful anaesthetic in the future.
围手术期过敏反应可为麻醉医生带来诊断和管理方面的挑战。本文强调了围手术期过敏反应诊断困难的问题，并介绍了近期危及生命的过敏反应急性管理指南中的建议。
麻醉医生在调查围手术期过敏反应中发挥着关键作用。在疑似围手术期过敏事件中，应测量血清胰蛋白酶水平以帮助进行后续过敏调查。此外，麻醉医生可以通过详细记录事件、详细说明症状、治疗方法和药物使用的时间顺序，确保向过敏科进行高质量转诊。
围手术期过敏反应罕见但可能危及生命。为了成功管理，应保持高度怀疑。只要怀疑围手术期过敏反应，麻醉医生与调查患者的过敏团队之间的密切合作至关重要，以便对患者进行适当的调查，并确保未来的麻醉过程顺利。
