• Vincent R van Cuilenborg, Jeroen Hermanides, Elke M E Bos, Markus W Hollmann, Benedikt Preckel, Fabian O Kooij, and Ingrid Terreehorst.
• Dutch Perioperative Allergy Centre, Amsterdam University Medical Centres, Location AMC, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands; Department of Anaesthesiology, Amsterdam University Medical Centres, Location AMC, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands. Electronic address: v.r.vancuilenborg@amsterdamumc.nl.
• Best Pract Res Clin Anaesthesiol. 2021 May 1; 35 (1): 11-25.

AbstractPerioperative allergic reactions are rare, yet important complications of anesthesia. Severe, generalized allergic reactions called anaphylaxis are estimated to have a mortality of 3.5-4.8%. Adequate recognition and handling of a severe perioperative anaphylactic reaction result in better outcomes, including less hypoxic-ischemic encephalopathy and death. The diagnosis of a perioperative allergic reaction can be difficult as the list of possible culprits of a perioperative allergic reaction is extensive. Making an informed guess on the causative agent and avoiding this agent in future anesthesia procedures is undesirable and unsafe. Therefore, to ensure future patient safety, a thorough investigation following a perioperative allergic reaction is mandatory. A collaborate approach by allergists and anesthesiologists is advised. In this article, we discuss the basic approach of the allergic patient and of patients with a suspected allergy to perioperatively administered medication.Copyright © 2020 Elsevier Ltd. All rights reserved.

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