37 Features of 51 Patients With Perioperative Anaphylaxis History

BACKGROUND: To evaluate the prevalence and the etiology of perioperative anaphylaxis (APEO) referred to an outpatient clinic specialized in adverse drug reactions. METHODS: We evaluated 806 patients throw the questionnaire “European Network for Drug Allergy” (ENDA) in the period from October 2006 to June 2011. Patients with a history of APEO were selected. The diagnostic criteria for anaphylaxis were based on the World Allergy Organization. Etiological investigation was made with skin tests for latex, neuromuscular blockers (NMBs), antibiotics, hypnotics, opioids and local anesthetics. Provocation tests for antibiotics, NSAIDs, local anesthetics and latex were also done. Specific IgE was tested for antibiotics (Penicillin G and V, Ampicillin and amoxicillin) and latex. RESULTS: We identified 51 (6%) patients with a history of APEO. Among them, 16 patients (31%) had hypersensitivity reactions with positive cutaneous test, 14 patients (27%) abandoned the investigation and 8 patients (16%) completed the investigation with all tests negative. Currently 12 patients (23%) are being investigated and one of them (2%) performed tests to drugs to use in the next sirgury. The main cause of APEO was latex allergy (22%), followed by NMB hypersensitivity (6%). Three patients had positive tests for 2 different agents. CONCLUSIONS: Latex allergy is the main cause of APEO in this study. The importance of testing all the possible agents involved was demonstrated by the occurrence of 3 cases with positive test for 2 agents.