Herman D, Dry J
Ann Anesthesiol Fr. 1976;17(2):125-30.
The notion of anaphylactic shock under anaesthesia implies sensitization, with a minimum delay of 1 week, on the occasion either of a previous anaesthesia with the responsible product, or with taking a drug with common antigenic determinants. Clinically this is reflected by the rapid and explosive appearance of symptoms which are always comparable: tendency to vascular collapse, respiratory bronchospastic distress, erythematous rash and Quincke's edema, gastrointestinal disorders, etc. These signs and symptoms of anaphylactic shock are closely related to the pharmacological actions of substances liberated during the reaction, of reaginic orgin (histamine, S.R.S.A.). It is reproduced by the direct effects of numerous anaesthetics on the liberation of theses very substances without the intermediary of an immunological mechanism. In consequence, the clinical argument alone is not sufficient to assert the true anaphylactic nature of a shock. Consequently, the elements of the history must be strongly borne in mind: notion ofsensitization during a previous anaesthesia, to the responsible product or to a drug which could have a crossed antigenicity with it.
麻醉下过敏性休克的概念意味着致敏，至少延迟1周，这发生在既往使用相关药物进行麻醉时，或服用具有共同抗原决定簇的药物时。临床上，这表现为症状迅速且突发出现，总是具有可比性：倾向于血管性虚脱、呼吸性支气管痉挛窘迫、红斑皮疹和昆克水肿、胃肠道紊乱等。这些过敏性休克的体征和症状与反应过程中释放的具有反应素性质的物质（组胺、慢反应物质-A）的药理作用密切相关。许多麻醉药可直接作用于这些物质的释放，而无需免疫机制介导，即可再现上述症状。因此，仅凭临床症状不足以断定休克的真正过敏性本质。因此，必须牢记病史要素：既往麻醉期间对相关药物或与之可能存在交叉抗原性的药物的致敏情况。
