© The Board of Management and Trustees of the British Journal of Anaesthesia 2004
Editorial III: Anaphylaxis and anaesthesiaall clear now?
Department of Anaesthesia, University of Liverpool, University Clinical Department, Duncan Building, Daulby Street, Liverpool L69 3GA, UK
E-mail: A.D.Axon@liverpool.ac.uk
| The first 150 words of the full text of this article appear below. |
In 2003, the Association of Anaesthetists of Great Britain and Ireland published the second revision of its Guidelines on the Management of Anaphylaxis.1 The model anaphylaxis drill, which all anaesthetists must know by rote, underlines the critical importance of intravenous epinephrine, given promptly, in saving lives. However, anaphylaxis remains a challenging condition to treat: 10% of anaesthesia-related reactions reported to the UK Medicines Control Agency (MCA) are still fatal.1 Interestingly, in 6
years only 361 reactions were reported to them.1 In contrast, in France, which has a well-established scheme for reporting reactions, 789 patients were recorded in a 2-yr period.2 Anaesthetists routinely give many potentially causative agents, perhaps too rapidly and in quick succession, and are therefore the medical practitioners most likely to see severe anaphylaxis.
What is anaphylaxis?
Most of us understand the pathological process involving the IgE-mediated release of vasoactive substances from mast cells and basophils after exposure to an
Incidence and causative agents
Neuromuscular blocking drugs
Clinical presentation
Investigation
Cross-reactivity
Conclusions
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