Review article
DIAGNOSIS OF PERIOPERATIVE ANAPHYLAXIS
Mirjana Turkalj
; Srebrnj/ak Children's Hospital, Zagreb, Croatia
Damir Erceg
; Srebrnj/ak Children's Hospital, Zagreb, Croatia
Marija Martinuš
; General Hospital Varaždin, Department of Anesthesiology, Reanimatology and Intensive Care, Varaždin, Croatia
Emil Babić
; Department of Internal Medicine, University Hospital Mostar, Mostar, Bosnia and Herzegovina
Maja Karin
; Department of Internal Medicine, University Hospital Mostar, Mostar, Bosnia and Herzegovina
Mateo Bevanda
; Department of Internal Medicine, University Hospital Mostar, Mostar, Bosnia and Herzegovina
Abstract
Every agent used during the perioperative period may be involved and have the potential to trigger both allergic, IgE and non–
IgE reaction as well as non-specific (non-allergic) reactions. In many cases, an allergic mechanism cannot be ruled out and systematic investigations should be tested of all drugs and agents the patient was exposed to prior to the reaction. The complexity of agents used for anaesthesia and surgery present challenges when attempting to identify the culprit drugs and select proper testing to better recognition of trigger. The diagnosis of preoperative anaphylactic or anaphylactoid reaction is clinical and based upon the presence of characteristic symptom and signs that begin suddenly and developed rapidly in most cases. Elevations of mast cell mediators such as tryptase and histamine in the blood can help to distinguish anaphylaxis from other disorders that present with similar clinical picture. The secondary investigations of adverse perioperative drug reactions are highly specialised and include skin testing, in vitro testing and in some cases challenge tests. Any suspected reaction during anaesthesia must be extensively investigated and these diagnostic tests should be done in specialised centres. The cooperation between anaesthesiologists and allergists is
necessary to provide the necessary diagnostic tests to identify the responsible drug, to carry out prevention and to provide recommendations for future anesthetic procedures.
Keywords
anaphylaxis; perioperative; anaestesia; apahlactoid reactions; diagnostic tests
Hrčak ID:
262699
URI
Publication date:
4.4.2019.
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