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Pediatric Patients with Previous Anaphylactic Reactions to General Anesthesia: a Review of Literature, Case Report, and Anesthetic Considerations

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单位: [1]Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing 100730, China [2]Department of Anesthesiology, China-Japan Friendship Hospital, Beijing, China [3]Department of Anesthesiology, Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China [4]Department of Stomatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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关键词: Pediatric patients Anaphylaxis Anesthesia Skin test Neuromuscular block agents

摘要:
Purpose of Review It is rare to see pediatric patients with previous perioperative anaphylaxis receiving future anesthesia, but it is critical to understand how to choose assessments, interpret the results, and develop a future anesthetic plan. Recent Findings Analysis of the results revealed that patients, at any age, regardless of sex and nationality, and the number of surgeries, have the risk of perioperative anaphylaxis while the risk of allergy increases as patients present multiple surgical events or have a previous history of atopy. 94.7% of pediatric patients with allergy testing after perioperative anaphylaxis tolerated subsequent general anesthesia without complications. Specific IgE tests, basophil activation tests, and skin tests are not available and suitable for all culprits. The early skin test could be considered a supplement for later testing. Drug challenge test is the golden standard but can only be used as the last resort. If general anesthesia is inevitable, avoidance of the culprit and use of alternative agents can help the patients prevent another potential recurrence. Full use of inhalation anesthesia without unnecessary neuromuscular blockade agents and avoidance of latex is recommended when the surgery is urgent or skin tests for children cannot be performed in time. This review summarizes characteristics of perioperative pediatric anaphylaxis, main tests for various drugs, and their sensitivities and specificities as well as recommendations as to how to implement safe anesthesia in the future.

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出版当年[2019]版
大类 | 3 区 医学
小类 | 3 区 过敏 3 区 免疫学
最新[2025]版
大类 | 2 区 医学
小类 | 2 区 过敏 2 区 免疫学
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出版当年[2018]版:
Q2 ALLERGY Q2 IMMUNOLOGY
最新[2023]版:
Q1 ALLERGY Q1 IMMUNOLOGY

影响因子: 最新[2023版] 最新五年平均[2021-2025] 出版当年[2018版] 出版当年五年平均[2014-2018] 出版前一年[2017版] 出版后一年[2019版]

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第一作者单位: [1]Department of Anesthesiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing 100730, China
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