Association between sugammadex and anaphylaxis in pediatric patients: A nested case-control study using a national inpatient database
Association between sugammadex and anaphylaxis in pediatric patients: A nested case-control study using a national inpatient database
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DOI：
10.1111/pan.13401
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发表时间：
2018-07-01
影响因子：
1.7
通讯作者：
Yasunaga, Hideo
中科院分区：
文献类型：
--
作者：
Tadokoro, Fumino;Morita, Kojiro;Yasunaga, Hideo
背景Sugammadex在麻醉期间用作逆转药。虽然有几个病例报告描述了sugammadex输注后的过敏反应，但对sugammadex与过敏反应之间的关系知之甚少，目的本回顾性研究的目的是调查sugammadex与胰岛素的相关性，接受全身麻醉的儿科患者的医院过敏反应。方法我们在日本国家住院患者数据库中确定了7月至12月期间接受全身麻醉的患者。2010年和2016年3月。我们在有和没有围手术期过敏反应的患者之间进行了1-4例病例对照匹配。我们使用条件logistic回归分析计算sugammadex使用和过敏反应发生的调整优势比，并调整麻醉持续时间、抗生素和输血。结果在835405例接受全身麻醉的患者中，我们确定了149名（0.018%）过敏性休克患者和472名（0.056%）过敏性休克相关体征/症状和皮肤损伤的组合。sugammade的使用与过敏性休克无显着相关性（比值比，0.80; 95%置信区间，0.53-1.21; P = 0.29）或过敏反应相关体征/症状和皮肤病变的组合（比值比，1.25; 95%可信区间，0.97-1.60; P = .08）.结论本研究显示sugammadex与全麻患儿围手术期过敏反应之间无显著相关性。
BackgroundSugammadex is used as a reversal drug during anesthesia. Although several case reports have described anaphylaxis following sugammadex infusion, little is known about the relationship between sugammadex and anaphylaxis, particularly in pediatric patients.AimsThe aim of this retrospective study was to investigate the association between sugammadex and in-hospital anaphylaxis in pediatric patients who underwent general anesthesia.MethodsWe identified patients who underwent general anesthesia in a Japanese national inpatient database between July 2010 and March 2016. We conducted 1-4 case-control matching between patients with and without perioperative anaphylaxis. We calculated the adjusted odds ratio for sugammadex use and occurrence of anaphylaxis, using a conditional logistic regression analysis with adjustment for duration of anesthesia, antibiotics, and blood transfusions.ResultsAmong 835 405 patients who underwent general anesthesia, we identified 149 (0.018%) patients with anaphylactic shock and 472 (0.056%) with a combination of anaphylaxis associated signs/symptoms and skin lesions. Sugammadex use was not significantly associated with anaphylactic shock (odds ratio, 0.80; 95% confidence interval, 0.53-1.21; P = .29) or the combination of anaphylaxis associated signs/symptoms and skin lesions (odds ratio, 1.25; 95% confidence interval, 0.97-1.60; P = .08).ConclusionThe present study showed no significant association between sugammadex and perioperative anaphylaxis in pediatric patients who underwent general anesthesia.