Anaesthesia and intensive care
-
Anaesth Intensive Care · Aug 1981
The epidemiology and clinical features of anaphylactic reactions in anaesthesia.
Severe anaphylactoid reactions during anaesthesia in 116 patients are described. The majority of patients who reacted to induction agents had previous exposure to the drug, while the majority of patients who reacted to muscle relaxants had not. There was a statistically significant increased incidence of allergy, atopy, asthma and previous reactions in patients who had reactions compared with a control group undergoing uneventful anaesthesia. ⋯ No one drug produced reactions that differed in severity or clinical features from any other drug. Clinical features included skin changes, oedema, cardiovascular collapse, bronchospasm, gastrointestinal symptoms, prolonged unconsciousness, convulsions and pulmonary oedema. Four patients died.
-
Anaesth Intensive Care · Aug 1981
The diagnosis of acute anaphylactoid reactions to anaesthetic drugs.
Patients with a presumptive diagnosis of an acute anaphylactoid reaction to anaesthesia were investigated to determine the cause of the reaction and the drug responsible by intradermal testing, patch and prick testing, sequential complement measurement, passive transfer testing and challenge. The most valuable information was provided by intradermal testing and a diagnosis could be made in 150 of 165 patients. When analphylactoid reactions to anaesthetic drugs occur, intradermal testing one month after the reaction and sequential complement measurements in the immediate post reaction period will enable the diagnosis to be established in the majority of cases. Intradermal testing is of no value for trivial reactions or reactions to colloid solutions or contrast media.