Université Sorbonne Paris Nord

education📍 Villetaneuse, France
3
Alpha-gal Syndrome Publications
2
Alpha-gal Syndrome Researchers

Associated Institutions

Laboratoire Analyse, Géométrie et Applications
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Laboratoire de physique des lasers
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Adaptateurs de Signalisation en Hématologie
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Laboratoire d’Ethologie Expérimentale et Comparée
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Laboratoire de Recherche Vasculaire Translationnelle
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Publications

Anaesthetic management of patients with pre-existing allergic conditions: a narrative review.

Dewachter P, Kopac P, Laguna JJ, Mertes PM, Sabato V, et al.
British journal of anaesthesia •

This narrative review seeks to distinguish the clinical patterns of pre-existing allergic conditions from other confounding non-allergic clinical entities, and to identify the potential related risks and facilitate their perioperative management. Follow-up investigation should be performed after a perioperative immediate hypersensitivity to establish a diagnosis and provide advice for subsequent anaesthetics, the main risk factor for perioperative immunoglobulin E (IgE)-mediated anaphylaxis being a previous uninvestigated perioperative immediate hypersensitivity reaction. The concept of cross-reactivity between drugs used in the perioperative setting and food is often quoted, but usually not supported by evidence. There is no reason to avoid propofol in egg, soy, or peanut allergy. The allergenic determinants have been characterised for fish, shellfish, and povidone iodine, but remain unknown for iodinated contrast agents. Iodinated drugs may be used in seafood allergy. Evidence supporting the risk for protamine allergy in fish allergy and in neutral protamine Hagedorn insulin use is lacking. Conversely, cross-reactivity to gelatin-based colloid may occur in α-gal syndrome. Atopy and allergic asthma along with other non-allergic conditions, such as NSAID-exacerbated respiratory disease, chronic urticaria, mastocytosis, and hereditary or acquired angioedema, are not risk factors for IgE-mediated drug allergy, but there is a perioperative risk associated with the potential for exacerbation of the various conditions.