Practical Guidelines for Perioperative Hypersensitivity Reactions
Laguna JJ (1,2), Archilla J (3), Doña I (4,2), Corominas M (5), Gastaminza G (6,2), Mayorga C (4,2), Berjes-Gimeno P (7), Tornero P (8), Martin S (3), Planas A (9), Moreno E (10,2), Torres MJ (4,2).
(1) Allergy Unit and Allergy-Anesthesia Unit, Hospital Central Cruz Roja, Madrid, Spain.
(2) Authors who participate in ISCIII RETIC ARADyAL.
(3) Anesthesia Unit, Hospital Central Cruz Roja, Madrid, Spain.
(4) Allergy Unit, Málaga Regional University Hospital-IBIMA, Málaga, Spain.
(5) Allergy Unit-Internal Medicine Department, Hospital Universitari de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Spain.
(6) Allergy and Clinic Immunology Department, Clínica Universidad de Navarra, Navarra, Spain.
(7) Allergy Unit, University Hospital Ramón y Cajal, Madrid, Spain.
(8) Allergy Unit, University Hospital Gregorio Marañón, Madrid, Spain.
(9) Anesthesia Unit, University Hospital La Princesa, Madrid, Spain.
(10) Allergy Unit, Salamanca University Hospital-IBSAL, Salamanca, Spain.
Perioperative hypersensitivity reactions constitute a first-line problem for anesthesiologists and allergists.
Therefore, hospitals should have a consensus protocol for the diagnosis and management of these reactions. However, this kind of protocol is not present in many hospitals, leading to problems with treatment, reporting of incidents, and subsequent etiological diagnosis.
In this document, we present a systematic review of the available scientific evidence and provide general guidelines for the management of acute episodes and for referral of patients with perioperative hypersensitivity reactions to allergy units.
Members of the Drug Allergy Committee of the Spanish Society of Allergy and Clinical Immunology (SEAIC) have created this document in collaboration with members of the Spanish Anesthesia Society (SEDAR). A practical algorithm is proposed for the etiologic diagnosis, and recommendations are provided for the management of hypersensitive patients.
CITATION J Investig Allergol Clin Immunol. 2018;28(4):216-232. doi: 10.18176/jiaci.0236. Epub 2018 Feb 7.