Article ; Online: Perioperative Anaphylaxis: Evaluation and Management.
Clinical reviews in allergy & immunology
2021 Volume 62, Issue 3, Page(s) 383–399
Abstract: Perioperative anaphylaxis (PA) is a rare but life-threatening condition that poses diagnostic and management challenges in the operating room. The incidence of severe perioperative reactions is estimated to be approximately 1:7000-10,000. Management ... ...
| Abstract | Perioperative anaphylaxis (PA) is a rare but life-threatening condition that poses diagnostic and management challenges in the operating room. The incidence of severe perioperative reactions is estimated to be approximately 1:7000-10,000. Management involves both immediate stabilization of the patient and identifying the culprit agent. Identification is essential to prevent recurrence of the event in subsequent surgeries and to avoid unnecessary labeling of drug allergy. Identifying all possible exposures including medications, disinfectants, latex, and dyes and choosing the appropriate tests are essential for proper evaluation. To identify the culprit, primary testing modalities include tryptase at the time of the reaction with subsequent levels and skin testing with nonirritating concentrations to the medications and substances utilized during the procedure and those potentially used as alternates. This strategy provides guidance for future surgeries and procedures. Close collaboration between the allergy, anesthesiology, and surgery teams is essential for appropriate management of these patients at the time of the reaction, during the post event evaluation and in preparation for subsequent surgeries. |
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| MeSH term(s) | Anaphylaxis/diagnosis ; Anaphylaxis/etiology ; Anaphylaxis/prevention & control ; Drug Hypersensitivity/diagnosis ; Drug Hypersensitivity/epidemiology ; Drug Hypersensitivity/therapy ; Humans ; Skin Tests/adverse effects ; Tryptases |
| Chemical Substances | Tryptases (EC 3.4.21.59) |
| Language | English |
| Publishing date | 2021-07-10 |
| Publishing country | United States |
| Document type | Journal Article ; Review |
| ZDB-ID | 1239045-8 |
| ISSN | 1559-0267 ; 1080-0549 |
| ISSN (online) | 1559-0267 |
| ISSN | 1080-0549 |
| DOI | 10.1007/s12016-021-08874-1 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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