Perioperative anaphylaxis

Abstract

Introduction: Anaphylaxis is a severe hypersensitivity reaction that is life-threatening for the patient. Diagnosis and perioperative management represent a challenge for the anesthesiologist, mainly due to the difficulty of making an adequate differential diagnosis and early resuscitation with adrenaline and fluid therapy. Objectives: To describe the epidemiology and clinical presentation of patients who present anaphylaxis during a surgical intervention with general or regional anesthesia in the operating room of the Arturo López Pérez Foundation during the years 2018 to 2022. Material and Method: Descriptive cross-sectional study. Nineteen patients were identified through the laboratory record of request for serum tryptase from the ward. Data were obtained from the electronic and physical clinical record. Results: 19 patients developed perioperative anaphylaxis, with a frequency of 1:1065 cases from 2018 to 2022. The main cause identified was latex. 61% of the reactions were grade 3, of which all received treatment with adrenaline. There were no deaths associated with anaphylactic shock. Conclusions: Perioperative anaphylaxis is a rare event in the ward, but with significant associated morbidity. A high index of suspicion is required for timely diagnosis and treatment. Contrary to what has been reported in Europe and North America, latex continues to be an important cause. Adrenaline as a cornerstone of management must be administered early. Follow-up must be carried out by an immunologist to detect the triggering cause and avoid future re-exposure.