Arslan Baris, Sahin Tuna, Ozdogan Hatice
Department of Anesthesia and Intensive Care, Adana City Training and Research Hospital, Adana, Turkey.
J Anaesthesiol Clin Pharmacol. 2021 Apr-Jun;37(2):153-159. doi: 10.4103/joacp.JOACP_383_19. Epub 2021 Jul 15.
In this study, the published sugammadex-induced anaphylaxis reports were reviewed to determine similarities in their presentation during anesthesia. PubMed was searched for sugammadex-induced anaphylaxis without time limitation. Reports were evaluated if they were in English and met the criteria of anaphylaxis determined by the World Allergy Organization. Two independent reviewers extracted and assessed the data using predesigned data collection forms. In total, 23 suitable articles were found and 33 sugammadex-induced anaphylaxis cases were included in the study. The mean age was 43.09 years (from 3-89 years) and 17 (51.5%) of the patients were female. Considering all reported cases, the average onset time of anaphylaxis was 3.08 min, with a median of 3 min (range 1-8 min). The most common signs and symptoms were hypotension, tachycardia, erythema, and desaturation. Of the 20 patients who underwent confirmatory skin testing, 15 had a positive skin reaction for sugammadex. Epinephrine was not given when indicated in about 25% of cases. Sugammadex-induced anaphylaxis onset time was less than 5 min in 92.3% of all the reported cases. Rapid diagnosis and early recognition of signs and symptoms of anaphylaxis are essential for a favorable prognosis. Treatment needs to be started as soon as possible to ensure the best outcome for the patient.
在本研究中，对已发表的舒更葡糖钠诱导的过敏反应报告进行了回顾，以确定其在麻醉期间表现的相似性。在PubMed上搜索无时间限制的舒更葡糖钠诱导的过敏反应报告。如果报告为英文且符合世界过敏组织确定的过敏反应标准，则对其进行评估。两名独立的审阅者使用预先设计的数据收集表提取和评估数据。总共找到了23篇合适的文章，33例舒更葡糖钠诱导的过敏反应病例被纳入研究。平均年龄为43.09岁（3至89岁），17名（51.5%）患者为女性。考虑到所有报告的病例，过敏反应的平均发作时间为3.08分钟，中位数为3分钟（范围1至8分钟）。最常见的体征和症状是低血压、心动过速、红斑和血氧饱和度下降。在接受确诊皮肤试验的20名患者中，15名对舒更葡糖钠有阳性皮肤反应。在约25%的病例中，有指征时未给予肾上腺素。在所有报告的病例中，92.3%的舒更葡糖钠诱导的过敏反应发作时间少于5分钟。快速诊断和早期识别过敏反应的体征和症状对于良好的预后至关重要。需要尽快开始治疗以确保患者获得最佳结果。
