139:
Anaphylaxis During Surgery and Medical Procedures
Saturday, March 3, 2018
South Hall A2 (Convention Center)
Maria Gabriela Torre, MD

RATIONALE: Anaphylaxis during anesthesia is an unpredictable, severe, and rare reaction. It has an in surgeries incidence of 1/10000 to 1/20000. In most series, the responsible drugs included neuromuscular blocking agents, latex, or antibiotics. There are no statistics of systemic allergic reactions during medical procedures. Investigation of anaphylaxis is a complex task, requiring testing all medications used during surgery. We present our experience in a retrospective study of 17 patients.

METHODS: Retrospective chart review from July 2011 to August 2017.

RESULTS: Twelve subjects developed anaphylaxis during surgery, 2 during endoscopy studies, 2 during trans-vaginal ultrasounds, and 1 during a dental procedure. Four surgeries were suspended due to reactions during induction of anesthesia, 5 were not completed and 3 went through. Both patients that presented a reaction during endoscopy required intensive care unit admission and all others were observed in an emergency room. All the medications used in the procedures, including latex, detergents and disinfectants were tested. The responsible drugs during surgery anaphylaxis were neuromuscular blocking agents, latex, patent blue and ranitidine. Ortho-phthalaldehyde (OPA), latex and amoxicillin were identified in endoscopy studies, transvaginal ultrasounds and the dental procedure respectively. The identification of the responsible drug allowed 7 patients to complete their surgery or diagnostic procedure uneventfully.

CONCLUSIONS: Responsible drug identification is crucial to reduce the anaphylactic risk in future interventions.