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全身麻醉过敏的原因及机制。

General anesthesia allergy causes and mechanisms.

作者信息

Lisiecka Maria Zofia

机构信息

Department of Allergology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland.

出版信息

Asia Pac Allergy. 2025 Sep;15(3):198-203. doi: 10.5415/apallergy.0000000000000199. Epub 2025 Mar 17.

Abstract

Allergic reactions to general anesthetics, though rare, can lead to severe complications. Genetic predisposition and prior allergic history are key risk factors, but the exact mechanisms remain under investigation. Effective preventive measures, such as pretesting and alternative drug selection, are essential to minimizing risks. The study aims to review the factors and processes underlying the development of allergic reactions to general anesthetics. As part of the study, a literature that contained data on patients undergoing general anesthesia was analyzed to identify cases of allergic reactions and their most probable causes. Available data on genetic factors and the previous allergic status of patients, which may affect the risk of developing an allergic reaction, were addressed. The results of the study showed that the development of allergic reactions during general anesthesia is an infrequent phenomenon, but cases of varying severity (from skin manifestations to anaphylaxis) occur. The analysis identified that genetic factors and a previous allergic status of a patient significantly increase the risk of developing allergies. The study also showed that the mechanisms of allergic reactions include both IgE-dependent and IgE-independent pathways, which requires a comprehensive approach to diagnosis. Furthermore, the study determined that several cases of allergic reactions during general anesthesia occurred due to the lack of preventive measures, including pretesting and sensitivity to anesthetic and the use of alternative drugs for patients at high risk of developing allergic reactions. The findings highlight the importance of collaboration among anesthetists, allergists, and surgeons to reduce the risk of allergy and ensure maximum patient safety. The data obtained can significantly impact the development of new protocols for managing allergic reactions and improving preoperative diagnostic methods for patients.

摘要

对全身麻醉药的过敏反应虽然罕见,但可能导致严重并发症。遗传易感性和既往过敏史是关键风险因素,但其确切机制仍在研究中。有效的预防措施,如术前检测和选择替代药物,对于将风险降至最低至关重要。该研究旨在回顾全身麻醉药过敏反应发生的因素和过程。作为研究的一部分,对包含全身麻醉患者数据的文献进行分析,以确定过敏反应病例及其最可能的原因。探讨了可能影响过敏反应发生风险的患者遗传因素和既往过敏状态的现有数据。研究结果表明,全身麻醉期间发生过敏反应是一种罕见现象,但会出现不同严重程度的病例(从皮肤表现到过敏反应)。分析确定,遗传因素和患者既往过敏状态会显著增加过敏发生风险。该研究还表明,过敏反应机制包括IgE依赖和IgE非依赖途径,这需要采用综合诊断方法。此外,研究确定,全身麻醉期间的几例过敏反应是由于缺乏预防措施,包括术前检测、对麻醉药的敏感性以及对过敏反应高风险患者使用替代药物。这些发现凸显了麻醉师、过敏症专科医生和外科医生之间合作对于降低过敏风险和确保患者最大安全的重要性。所获得的数据可显著影响管理过敏反应新方案的制定以及改善患者术前诊断方法。

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