Propofol anaphylaxis

True anaphylaxis to propofol has been observed (76). Infection risk... 

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. 

Committee on Safety of Medicines. Propofol - convulsions, anaphylaxis and delayed recovery from anaesthesia. Current Problems (1989) 26. 

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. 

Fentanyl (no details) Breathing difficulties, wheezing, frothy secretions LTT SPT Positive for fentanyl and proposol Positive for meperidine Anaphylaxis to fentanyl and propofol Diagnosis not firmly established. Could be anaphylactoid. No positive skin test for fentanyl. Relevance of LTT and meperidine SPT Cone, of meperidine SPT ... 

Immunologic Anaphylaxis with pulmonary edema has been described after the use of propofol at cesarean section [89 ]. 

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