Propofol allergy

Known sensitivity to propofol or the emulsion constituents (care with egg allergy). 

Hofer K N, McCarthy M W, Buck M L, et al. (2003). Possible anaphylaxis after propofol in a child with food allergy. Ann Pharmacother 37 398-401. 

C. Hypersensitivity to propofol or additives (sulfites). Allergy to soybean or eggs may be a relative contraindication. 

Although propofol is generally said to be a remarkably safe dmg, 14 patients were reported to have life-threatening reactions within a few minutes of the administration of propofol, numerous other anaphylactic-like reactions have been reported, and other occasionally observed hypersensitivity reactions include bronchospasm, angioedema, urticaria, and erythematous rash. The overall incidence of anaphylaxis induced by propofol in France is about 1 % and 0.65 % in the Australian survey (Table 7.1). Another survey estimated that 1.2 % of cases of perioperative anaphylactic shock were attributable to propofol. Risk factors for a reaction are said to be a history of previous dmg allergy and the use with atracu-rium, the latter because of possibly enhanced histamine release. 

In Asia allergies to soy are well known and an association of soybean allergy with propofol-induced anaphylaxis has been suggested. In a recent convincing case, anaphylaxis with severe oropharyngeal edema and bronchospasm occurred in a 74-year-old woman with a history of soy allergy a few minutes after receiving propofol. Skin prick tests revealed positive reactions to propofol and 20 % Intralipid which, like the propofol formulation, contains soybean oil. It was concluded that the anaphylactic reaction was caused by the soybean oil present in the administered propofol. 

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