Epidemiology of perioperative anaphylaxis in France in 2017-2018: the 11th GERAP survey.

Autor:	Tacquard C; Department of Anesthesia and Intensive Care, Strasbourg University Hospital, Strasbourg, France. Electronic address: charlesambroise.tacquard@chru-strasbourg.fr., Serrier J; Department of Immunology and Histocompatibility, Caen University Hospital, Caen, France., Viville S; Department of Anesthesia and Intensive Care, Strasbourg University Hospital, Strasbourg, France., Chiriac AM; Department of Pulmonology, Division of Allergy, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, IDESP, University of Montpellier, Montpellier, France., Franchina S; Perioperative Allergic Reaction Exploration Unit, Department of Anesthesia and Intensive Care, Rouen University Hospital, Rouen, France., Gouel-Cheron A; Paris City University, Paris, France; Department of Anaesthesiology and Critical Care Medicine, Bichat Hospital, AP-HP, Paris, France; Antibody in Therapy and Pathology, Pasteur Institute, INSERM, Paris, France., Giraudon A; Department of Anesthesiology and Critical Care, Bordeaux University Hospital, Bordeaux, France., Le Guen M; Department of Anesthesia and Pain Medicine, Université de Versailles Saint-Quentin, Versailles, France., Le Quang D; Department of Anaesthesia and Intensive Care, Lyon Sud University Hospital, Hospices Civils de Lyon, Lyon, France., Malinovsky JM; Department of Anesthesia, Robert-Debré University Hospital, Reims, France., Petitpain N; Regional Centre of Pharmacovigilance, University Hospital of Nancy, Nancy, France., Demoly P; Department of Pulmonology, Division of Allergy, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, IDESP, University of Montpellier, Montpellier, France., Mertes PM; Department of Anesthesia and Intensive Care, Strasbourg University Hospital, Strasbourg, France.
Jazyk:	angličtina
Zdroj:	British journal of anaesthesia [Br J Anaesth] 2024 Jun; Vol. 132 (6), pp. 1230-1237. Date of Electronic Publication: 2024 Mar 16.
DOI:	10.1016/j.bja.2024.01.044
Abstrakt:	Background: Perioperative anaphylaxis is rare but is associated with significant morbidity. This complication has been well described in France by the GERAP (Groupe d'Etude des Réactions Anaphylactiques Périopératoires), a network focused on its study. The epidemiology of perioperative anaphylaxis is evolving, influenced by environmental factors and clinical practice. The aim of this study was to update the epidemiology of perioperative anaphylaxis in France. Methods: This multicentre retrospective study was performed in 26 allergy clinics of the GERAP network in 2017-8. Results: There were 765 patients with perioperative anaphylaxis included. Most cases were severe, with 428 (56%) reactions graded as 3 or 4 according to the Ring and Messmer classification. Skin test results were available for 676 patients, with a culprit agent identified in 471 cases (70%). Neuromuscular blocking agents were the main cause of perioperative anaphylaxis (n=281; 60%), followed by antibiotics (n=118; 25%) and patent blue dye (n=11; 2%). Cefazolin was the main antibiotic responsible for perioperative anaphylaxis (52% of antibiotic-related reactions). Suxamethonium and rocuronium were the main neuromuscular blocking agents responsible for perioperative anaphylaxis with 7.1 (6.1-8.4) and 5.6 (4.2-7.4) reactions per 100,000 vials sold, respectively, whereas cefazolin-related cases were estimated at 0.7 (0.5-0.9) reactions per 100,000 vials sold. Conclusions: Our results confirm that most commonly identified triggering agents remain neuromuscular blocking agents. Reactions to antibiotics, particularly cefazolin, are becoming increasingly frequent. The origin of sensitisation to cefazolin is unknown, as no cross-sensitisation has been described, and it should be the subject of further study. Perioperative anaphylaxis should be followed over the years and understood given the changing triggers. Clinical Trial Registration: ClinicalTrials.gov (NCT04654923). (Copyright © 2024 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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