Hypersensitivity reactions during anesthesia. Results from the ninth French survey (2005-2007).
Hypersensitivity reactions during anesthesia. Results from the ninth French survey (2005-2007).
复制标题
麻醉期间的超敏反应。
作者：
Dong Sw;Paul;N. Petitpain;F. Hasdenteufel;Malinovsky Jm;Gerap
背景
麻醉过程中发生的超敏反应仍然是麻醉医生关注的主要原因。我们报告了在法国对麻醉期间观察到的超敏反应连续第九次调查的结果。这份报告将作为本次干预前的流行病学参考。
方法
2005年1月1日至2007年12月31日，1253名经历了免疫介导(IgE介导)或非免疫介导(非IgE介导)超敏反应的患者被转至40个参与中心之一。诊断建立在临床病史、皮试和/或特异性IgE检测的基础上。
结果
IgE介导和非IgE介导的反应分别为786例(63%)和467例(37%)。最常见的过敏反应原因是神经肌肉阻滞剂(NMBA)(373例，47.4%)、乳胶(158例，20%)和抗生素(141例，18.1%)。琥珀胆碱(N=226，60.6%)是最常见的NMBA，而当考虑到每个NMBA的市场份额时，涉及顺式阿曲库铵的反应频率很低(N=22，5.9%)。涉及活性染料的反应增加(N=34，4.4%)。
结论
过敏反应流行病学的这些变化证实了在围手术期定期对过敏反应进行流行病学调查的必要性。
BACKGROUND
Hypersensitivity reactions occurring during anesthesia remain a major cause of concern for anesthesiologists. We report the results of the ninth consecutive survey of hypersensitivity reactions observed during anesthesia in France. This report will be used as an epidemiologic reference prior to this intervention.
METHODS
Between January 1, 2005 to December 31, 2007, 1253 patients who experienced an immune-mediated (IgE-mediated) or non-immune-mediated (non-IgE-mediated) hypersensitivity reaction were referred to one of the 40 participating centers. Diagnosis was established on the basis of clinical history, skin tests and/or specific IgE assay.
RESULTS
An IgE-mediated or non-IgE-mediated reaction was diagnosed in 786 cases (63%) and 467 cases (37%), respectively. The most common causes of anaphylaxis were neuromuscular blocking agents (NMBA) (N.=373, 47.4%), latex (N.=158, 20%), and antibiotics (N.=141, 18.1%). Succinylcholine (N.=226, 60.6%) was the most frequently incriminated NMBA, whereas the low frequency of reactions involving cis-atracurium was confirmed (N.=22, 5.9%) when market shares of each NMBA were taken into account. An increased number of reactions involving vital dyes was recorded (N.=34, 4.4%).
CONCLUSION
These changes in the epidemiology of allergic reactions confirm the need for regular epidemiologic surveys of anaphylaxis in the perioperative period.