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

Abstract

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. 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. 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. Our results confirm that antibiotics and neuromuscular blocking agents are common causative agents of perioperative anaphylaxis in the United Kingdom.