Anaphylaxis during general anaesthesia: experience from a drug allergy centre in the UK

Abstract

Background: Anaphylaxis during general anaesthesia is rare but often severe. Identification of the cause of anaphylaxis and recommendation of a range of drugs or agents likely to be safer for future surgery is a collaborative venture between the allergists and the anaesthesiologists, but it often poses a significant challenge. Methods: A total of 31 patients who attended the Drug Allergy Unit at University College London Hospital with suspected perioperative anaphylaxis between March 2013 and January 2016 were reviewed retrospectively. Results: The culprit drug was identified in 21 patients (67.7%): antibiotics (n = 11, 52.3%), neuromuscular blocking agents (n = 8, 38.1%), morphine (n = 1, 4.8%) and gelofusine (n = 1, 4.8%). No cause was identified in six patients (19.4%), and four patients (12.9%) had non-allergic reactions. Conclusion: Our results confirm that antibiotics and neuromuscular blocking agents are common causative agents of perioperative anaphylaxis in the United Kingdom.