By Jerrold H. Levy
This publication offers anaesthetists with a pragmatic method of the popularity, knowing, and administration of life-threatening reactions to anaesthesia and different medications used in the course of surgical procedure and within the ICU
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Extra info for Anaphylactic Reactions in Anesthesia and Intensive Care
Bronchospasm may occur during laryngoscopy and intubation under light planes of anesthesia. Urticaria and hypotension often occur following rapid administration of narcotics, d-tubocurarine, or vancomycin. An immunologie mechanism for most clinically suspected immediate hypersensitivity reactions during anesthesia is difficult to prove. Only half of all reported reactions in the literature have demonstrated the cause. Allergy is suspected because the reaction occurs after the administration of a drug.
Heroin may cause pulmonary edema and death in drug addicts; however, this finding may represent injected impurities such as talc or casein to which the addict is sensitized. Codeine has been implicated in several cases of anaphylactoid reactions; however, in these instances more than one drug was used simultaneously. 130 An anaphylactoid reaction to morphine has been reported, but skin testing in this patient produced negative results. Meperidine is the only narcotic with which true anaphylaxis and IgE antibodies have been demonstrated by radioallergosorbent testing.
Prostaglandins are potent mediators of the inflammatory response and can induce bronchospasm, pulmonary artery hypertension, and peripheral vasodilation. Mast cells in lung parenchyma of humans may be a major source of prostaglandin synthesis. Anaphylactic challenge of human lung mast cells in vitro liberates primarily prostaglandin D2 but also thromboxane A2 and prostaglandin F 2 a. 2 End organ effects of the specific prostaglandins are given in the following sections. Prostaglandin D2. 408 It increases nondirected migration of polymorphonuclear leukocytes and inhibits enzyme release induced by other agents.
Anaphylactic Reactions in Anesthesia and Intensive Care by Jerrold H. Levy