Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Anesthesiology, Allergy, Anaphylaxis, Anesthesia complications, Perioperative period, PERIOPERATIVE ANAPHYLAXIS, WESTERN-AUSTRALIA, 1103 Clinical Sciences, 3202 Clinical sciences

Abstract:

© Acta Anaesthesiologica Belgica, 2018. Background: Since 2008, Belgian anesthe siologists can report suspected anaphylactic reactions during anesthesia on the website of the Society for Anesthesia and Resuscitation of Belgium (SARB). Material & Methods: We analyzed the database retrospectively, covering a period from January 2008 to May 2013. Results: Out of 97 cases, two were excluded because of insufficient data. Fifty-six % of cases were reported by the 2 hospitals that conducted the survey. The incidence of severe reactions was higher in regional hospitals than in university hospitals. Respiratory symptoms were more frequent in patients with a history of respiratory disease. Mast cell tryptase (MCT) after the reaction was measured correctly in only 54% of cases, and was positive in 66% of cases (MCT > 13.5 figfL). Basal MCT was measured in 64% of patients. Skin testing was done in 72% and was positive in 51 (75%) of them. Most frequently incriminated agents were neuromuscular blocking drugs (NMBDs) (63%) and antibiotics (18%). Cross-sensitivity between NMBDs occurred in 78% of cases. A complete investigation (MCT at 30-90 min, basal MCT at distance from the reaction, and skin testing) was conducted in 38% of cases. Conclusion: There was probably severe underreporting of suspected anaphylactic reactions in Belgium. Moreover, in a majority of cases, necessary investigations were carried out incompletely. Underreporting and incomplete investigation increases the risk for new episodes of anaphylaxis during subsequent anesthesia.