General anesthesia anaphylaxis

It has also been aigued that chymopapain injection under local, rather than under general, anesthesia is associated with a lower risk for anaphylaxis [88] another advantage of chymopapain under local anesthesia is the fact that the patient will react if the injection needle comes In close contact with the nerve root [89]. Indeed, injection of chymopapain into the nerve root must he avoided because chymopapain can cause neural injury if it comes in direct contact with the nervous tissue. 

The diagnosis of an allergic reaction to a muscle relaxant is based on clinical features, measurement of histamine and tryptase concentrations in the plasma during the reaction, and subsequent skin testing a few weeks later. However, during general anesthesia isolated sjmptoms can occur, most often hypotension or bronchospasm. Therefore, the clinical features of anaphylaxis may not be recognized as such. 

Immunologic Refractory shock from anaphylaxis can occur after induction of general anesthesia [4 ]. Raised serum concentrations of tryptase and IgE to suxamethonium confirmed anaphylaxis to suxamethonium in these two patients. Hypotension was refractory to terlipressin in both cases and to extracorporeal membrane oxygenation in one. However, both interventions were instituted after a prolonged period of resuscitation. Methythioninium chloride, glucagon, and Qti-adrenoceptor agonists have been proposed as alternative therapeutic... 

Latex. Allergy to natural rubber latex is the second most common cause of anaphylaxis during anesthesia in the general population. In children subjected to numerous operations, particularly those suffering from spina bifida, it is the primary cause of anaphylaxis [11]. The relative frequency of allergy to latex has rapidly increased, rising from 0.5% before 1980 to 20% in France in 2002. A low rate has been reported in countries where a strategy aimed to reduce latex exposure was implemented [6]. 

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