Clinical criteria for proper diagnosis and treatment of perioperative anaphylaxis

Authors

DOI:

https://doi.org/10.33448/rsd-v10i13.21423

Keywords:

Perioperative anaphylaxis; Anaphylactic shock; Anaphylactic reaction.

Abstract

Perioperative anaphylaxis is an unpredictable, severe and systemic hypersensitivity reaction mediated by IgE or non-mediated immunoglobulins, difficult to diagnose and potentially fatal. Furthermore, it is important to mention that perioperative IgE-mediated anaphylaxis is directly related to agents administered intravenously, occurring after anesthesia, with neuromuscular blocking agents (NMBs) and antibiotics being the main causal agents. After administration of the allergen, the evolution of the patient can range from only side effects, similar to those of medications in use, to serious evolutions such as cardiorespiratory arrests, showing a need to spread the theoretical and technical domain of the management of these situations to obtain better results. predictions. The mainstay of treatment for perioperative anaphylaxis includes: maintaining the airway patent, providing 100% oxygen, administering intramuscular (IM) or intravenous (IV) epinephrine, and volume replacement. Thus, since the patient can die in minutes, due to the acute situation intensifying quickly, urgent treatment is necessary. And for that, the present work brings the elucidation of diagnostic criteria (clinical picture, evolution and associated exams). In addition, it clarifies the management for the treatment of patients in perioperative anaphylaxis. For this bibliographical research, the databases of PubMed, Latin American and Caribbean Literature in Health Sciences (LILACS) and MEDLINE were used as reference.

References

Au, E., Lau, C. S., Lam, K., & Chan, E. (2020). Perioperative anaphylaxis and investigations: a local study in Hong Kong. Singapore medical journal, 61(4), 200–205. https://doi.org/10.11622/smedj.2019156

Caffarelli, C., Stringari, G., Miraglia Del Giudice, M., Crisafulli, G., Cardinale, F., Peroni, D. G., & Bernardini, R. (2011). Prevention of allergic reactions in anesthetized patients. International journal of immunopathology and pharmacology, 24(3 Suppl), S91–S99. https://doi.org/10.1177/03946320110240s313

Caimmi, S., Caimmi, D., Bernardini, R., Caffarelli, C., Crisafulli, G., Pingitore, G., & Marseglia, G. L. (2011). Perioperative anaphylaxis: epidemiology. International journal of immunopathology and pharmacology, 24(3 Suppl), S21–S26. https://doi.org/10.1177/03946320110240s304

Dewachter, P., & Savic, L. (2019). Perioperative anaphylaxis: pathophysiology, clinical presentation and management. BJA education, 19(10), 313–320. https://doi.org/10.1016/j.bjae.2019.06.002

Garvey, L. H., Dewachter, P., Hepner, D. L., Mertes, P. M., Voltolini, S., Clarke, R., Cooke, P., Garcez, T., Guttormsen, A. B., Ebo, D. G., Hopkins, P. M., Khan, D. A., Kopac, P., Krøigaard, M., Laguna, J. J., Marshall, S., Platt, P., Rose, M., Sabato, V., Sadleir, P., & Kolawole, H. (2019). Management of suspected immediate perioperative allergic reactions: an international overview and consensus recommendations. British journal of anaesthesia, 123(1), e50–e64. https://doi.org/10.1016/j.bja.2019.04.044

Haque, S. H., & Nossaman, B. D. (2012). Dyed but not dead. The Ochsner journal, 12(2), 135–140.

Kolawole, H., Marshall, S. D., Crilly, H., Kerridge, R., & Roessler, P. (2017). Australian and New Zealand Anaesthetic Allergy Group/Australian and New Zealand College of Anaesthetists Perioperative Anaphylaxis Management Guidelines. Anaesthesia and intensive care, 45(2), 151–158. https://doi.org/10.1177/0310057X1704500204

Lagopoulos, V., & Gigi, E. (2011). Anaphylactic and anaphylactoid reactions during the perioperative period. Hippokratia, 15(2), 138–140.

Lavery, W. J., & Bernstein, J. A. (2019). Cyclical hypersensitivity, anaphylaxis, and related hormonal reaction. Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology, 122(2), 140–147. https://doi.org/10.1016/j.anai.2018.11.016

Manfredi, G., Pezzuto, F., Balestrieri, A., Lo Schiavo, M., Montera, M. C., Pio, A., Iannelli, M., Gargano, D., Bianchi, M. J., Casale, G., Galimberti, M., Triggiani, M., & Piazza, O. (2013). Perioperative anaphylactic risk score for risk-oriented premedication. Translational medicine @ UniSa, 7, 12–17.

Marinho, S., Kemp, H., Cook, T. M., Farmer, L., Farooque, S., Lucas, D. N., Garcez, T., Floss, K., Torevell, H., Thomas, M., Warner, A., Hitchman, J., Ferguson, K., Egner, W., Nasser, S., Karanam, S., Kong, K. L., McGuire, N., Bellamy, M., & Harper, N. (2018). Cross-sectional study of perioperative drug and allergen exposure in UK practice in 2016: the 6th National Audit Project (NAP6) Allergen Survey. British journal of anaesthesia, 121(1), 146–158. https://doi.org/10.1016/j.bja.2018.04.016

Misbah, S. A., & Krishna, M. T. (2019). Peri-Operative Anaphylaxis-An Investigational Challenge. Frontiers in immunology, 10, 1117. https://doi.org/10.3389/fimmu.2019.01117

Moura, A. L., Regateiro, F., Coutinho, I. A., Mota, D. S., Paiva, A., Bom, A. T., & Faria, E. (2020). Recurrent peripartum anaphylaxis as a manifestation of systemic mastocytosis. Revista portuguesa de imunoalergologia, 28(4), 241-246. https://doi.org/http://doi.org/10.32932/rpia.2020.12.047

Nel, L., & Eren, E. (2011). Peri-operative anaphylaxis. British journal of clinical pharmacology, 71(5), 647–658. https://doi.org/10.1111/j.1365-2125.2011.03913.x

Pajno, G. B., Crisafulli, G., Caminiti, L., Marseglia, G. L., Cardinale, F., Paravati, F., & Caffarelli, C. (2011). Perioperative allergy: therapy. International journal of immunopathology and pharmacology, 24(3 Suppl), S101–S104. https://doi.org/10.1177/03946320110240s314

Ribeiro, M., Chong Neto, H. J., & Rosario Filho, N. A. (2017). Diagnosis and treatment of anaphylaxis: there is an urgent needs to implement the use of guidelines. Einstein (Sao Paulo, Brazil), 15(4), 500–506. https://doi.org/10.1590/S1679-45082017RW4089

Spindola, M., Solé, D., Aun, M. V., Azi, L., Bernd, L., Garcia, D. B., Capelo, A. V., Cumino, D. O., Lacerda, A. E., Lima, L. C., Morato, E. F., Nunes, R. R., Rubini, N., da Silva, J., Tardelli, M. Â., Watanabe, A. S., Curi, E. F., & Sano, F. (2020). Atualização sobre reações de hipersensibilidade perioperatória: documento conjunto da Sociedade Brasileira de Anestesiologia (SBA) e Associação Brasileira de Alergia e Imunologia (ASBAI) – Parte I: tratamento e orientação pós‐crise [Update on perioperative hypersensitivity reactions: joint document of the Brazilian Society of Anesthesiology (SBA) and Brazilian Association of Allergy and Immunology (ASBAI) - Part I: post-crisis guidelines and treatment]. Brazilian journal of anesthesiology (Elsevier), 70(5), 534–548. https://doi.org/10.1016/j.bjan.2020.06.004

Rother, E. T., & Braga, M. E. R. (2005). Como Elaborar Sua Tese: Estrutura e Referências (4th ed.). BC Gráfica.

Spindola, M., Solé, D., Aun, M. V., Azi, L., Bernd, L., Garcia, D. B., Capelo, A. V., Cumino, D. O., Lacerda, A. E., Lima, L. C., Morato, E. F., Nunes, R. R., Rubini, N., da Silva, J., Tardelli, M. Â., Watanabe, A. S., Curi, E. F., & Sano, F. (2020). Atualização sobre reações de hipersensibilidade perioperatória: documento conjunto da Sociedade Brasileira de Anestesiologia (SBA) e Associação Brasileira de Alergia e Imunologia (ASBAI) – Parte I: tratamento e orientação pós‐crise [Update on perioperative hypersensitivity reactions: joint document of the Brazilian Society of Anesthesiology (SBA) and Brazilian Association of Allergy and Immunology (ASBAI) - Part I: post-crisis guidelines and treatment]. Brazilian journal of anesthesiology (Elsevier), 70(5), 534–548. https://doi.org/10.1016/j.bjan.2020.06.004

Solé, D., Spindola, M., Aun, M. V., Araújo Azi, L., Bernd, L., Garcia, D. B., Capelo, A. V., Cumino, D. O., Lacerda, A. E., Lima, L. C., Morato, E. F., Nunes, R. R., Rubini, N., da Silva, J., Tardelli, M. A., Watanabe, A. S., Curi, E. F., & Sano, F. (2020). Atualização sobre reações de hipersensibilidade perioperatória: documento conjunto da Sociedade Brasileira de Anestesiologia (SBA) e Associação Brasileira de Alergia e Imunologia (ASBAI) – Parte II: etiologia e diagnóstico [Update on perioperative hypersensitivity reactions: joint document from the Brazilian Society of Anesthesiology (SBA) and Brazilian Association of Allergy and Immunology (ASBAI) - Part II: etiology and diagnosis]. Brazilian journal of anesthesiology (Elsevier), 70(6), 642–661. https://doi.org/10.1016/j.bjan.2020.08.008

Turkalj, M., Erceg, D., Martinuš, M., Babić, E., Karin, M., & Bevanda, M. (2019). Diagnosis of perioperative anaphylaxis. Psychiatria Danubina, 31(Suppl 1), 50–59.

Yim Rebecca. (2016). An Update on Perioperative anaphylaxis. World Federations Societies of Anesthesiologists. ATOTW Tutorial 324. págs. 1-6.

Yoon, S. H., Bang, J. Y., Seo, H., & Song, J. G. (2014). Sudden cardiovascular collapse caused by severe anaphylaxis after cisatracurium use: a case report. Korean journal of anesthesiology, 67(6), 412–415. https://doi.org/10.4097/kjae.2014.67.6.412

Published

16/10/2021

How to Cite

SOUSA, L. F. T. de .; ALVES, E. A. S. .; OLIVEIRA, V. M. G. de .; AMARAL, M. H. .; CAVALCANTE, C. P. A. .; BALDAÇARA, R. P. de C. . Clinical criteria for proper diagnosis and treatment of perioperative anaphylaxis. Research, Society and Development, [S. l.], v. 10, n. 13, p. e375101321423, 2021. DOI: 10.33448/rsd-v10i13.21423. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/21423. Acesso em: 6 dec. 2021.

Issue

Section

Health Sciences