Comparative epidemiology of suspected perioperative hypersensitivity reactions

Paul Michel Mertes; Didier G Ebo; Tomaz Garcez; Michael Rose; Vito Sabato; Tomonori Takazawa; Peter J Cooke; Russell C Clarke; Pascale Dewachter; Lene H Garvey; Anne B Guttormsen; David L Hepner; Phil M Hopkins; David A Khan; Helen Kolawole; Peter Kopac; Mogens Krøigaard; Jose J Laguna; Stuart D Marshall; Peter R Platt; Paul H M Sadleir; Louise C Savic; Sinisa Savic; Gerald W Volcheck; Susanna Voltolini

doi:10.1016/j.bja.2019.01.027

Comparative epidemiology of suspected perioperative hypersensitivity reactions

Br J Anaesth. 2019 Jul;123(1):e16-e28. doi: 10.1016/j.bja.2019.01.027. Epub 2019 Mar 4.

Authors

Paul Michel Mertes¹, Didier G Ebo², Tomaz Garcez³, Michael Rose⁴, Vito Sabato², Tomonori Takazawa⁵, Peter J Cooke⁶, Russell C Clarke⁷, Pascale Dewachter⁸, Lene H Garvey⁹, Anne B Guttormsen¹⁰, David L Hepner¹¹, Phil M Hopkins¹², David A Khan¹³, Helen Kolawole¹⁴, Peter Kopac¹⁵, Mogens Krøigaard¹⁶, Jose J Laguna¹⁷, Stuart D Marshall¹⁴, Peter R Platt⁷, Paul H M Sadleir¹⁸, Louise C Savic¹⁹, Sinisa Savic²⁰, Gerald W Volcheck²¹, Susanna Voltolini²²

Affiliations

¹ Department of Anesthesia and Intensive Care, Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Strasbourg, France. Electronic address: paul-michel.mertes@chru-strasbourg.fr.
² Department of Immunology, Allergology and Rheumatology, University of Antwerp, Antwerp University Hospital, Antwerp, Belgium.
³ Department of Immunology, Manchester University NHS Foundation Trust, Manchester, UK.
⁴ Northern Clinical School, University of Sydney, Sydney, Australia; Department of Anaesthesia, Royal North Shore Hospital, Sydney, Australia.
⁵ Intensive Care Unit, Gunma University Hospital, Gunma, Japan.
⁶ Department of Anaesthesia and Perioperative Medicine, Auckland City Hospital, Auckland, New Zealand.
⁷ Department of Anaesthesia, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; Anaesthetic Allergy Referral Centre of Western Australia, Sir Charles Gairdner Hospital, Perth, Australia.
⁸ Department of Anesthesiology and Intensive Care, Groupe Hospitalier de Paris-Seine-Saint-Denis, Assistance Publique-Hôpitaux de Paris, Paris, France; Université Paris 13, Sorbonne-Paris-Cité, Paris, France.
⁹ Danish Anaesthesia Allergy Centre, Allergy Clinic, Department of Dermatology and Allergy, Copenhagen University Hospital, Gentofte, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
¹⁰ Department of Anaesthesia and Intensive Care, Haukeland University Hospital, Bergen, Norway; Department of Clinical Medicine, University of Bergen, Bergen, Norway.
¹¹ Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, MA, USA.
¹² Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.
¹³ Department of Internal Medicine, Division of Allergy and Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
¹⁴ Department of Anaesthesia and Perioperative Medicine, Monash University, Melbourne, Australia; Department of Anaesthesia, Peninsula Health, Melbourne, Australia.
¹⁵ Division of Allergology, University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.
¹⁶ Danish Anaesthesia Allergy Centre, Allergy Clinic, Department of Dermatology and Allergy, Copenhagen University Hospital, Gentofte, Denmark.
¹⁷ Allergy Unit, Allergo-Anaesthesia Unit, Hospital Central de la Cruz Roja, Faculty of Medicine, Alfonso X El Sabio University, ARADyAL, Madrid, Spain.
¹⁸ Department of Anaesthesia, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; Anaesthetic Allergy Referral Centre of Western Australia, Sir Charles Gairdner Hospital, Perth, Australia; Department of Pharmacology, University of Western Australia, Crawley, Australia.
¹⁹ Anaesthetic Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
²⁰ Department of Clinical Immunology and Allergy, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
²¹ Division of Allergic Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA.
²² Allergy Unit, S. Martino Policlinic Hospital, Genoa, Italy.

PMID: 30916015
DOI: 10.1016/j.bja.2019.01.027

Abstract

Suspected perioperative hypersensitivity reactions are rare but contribute significantly to the morbidity and mortality of surgical procedures. Recent publications have highlighted the differences between countries concerning the respective risk of different drugs, and changes in patterns of causal agents and the emergence of new allergens. This review summarises recent information on the epidemiology of perioperative hypersensitivity reactions, with specific consideration of differences between geographic areas for the most frequently involved offending agents.

Keywords: antibiotics; blood products; chlorhexidine; latex; neuromuscular blocking agents; perioperative anaphylaxis; perioperative hypersensitivity; sugammadex.

Publication types

Review

MeSH terms

Anaphylaxis / epidemiology*
Humans
Intraoperative Complications / epidemiology*
Postoperative Complications / epidemiology*