• F Escolano and P Sierra.
• Servicio de Anestesiología y Reanimación, Hospital de L'Esperança, Barcelona.
• Rev Esp Anestesiol Reanim. 1996 Jan 1;43(1):17-26.

AbstractAnaphylactic reaction during anesthesia is a constant source of concern for anesthesiologists, given that the rates of death and serious complications are high and predicting which patients will be susceptible is impossible. All substances used in the perioperative period carry a certain risk of releasing histamine and triggering an allergic reaction, though muscle relaxants are the drugs usually implicated. The incidence of serious anaphylaxis ranges between 1:4,000 and 1:23,000 anesthetic procedures, with mortality set at 3-9% and morbidity 10 times higher. Clinical signs vary from mild symptoms to anaphylactic shock and cardiac arrest. The diagnostic procedure to follow upon observing an allergic reaction is to first identify the responsible mechanism and later the responsible agent, as well as drugs that can be used safely. Prophylaxis is based mainly on recognizing predisposed patients before surgery and following recommendations and pharmacological protocols based on better understanding of the pathophysiological mechanisms that cause anaphylactic reaction and on experience in managing them.

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