Allergy In Anesthesia

Abstract

Allergic reactions during anesthesia are unpredictable and occasionally a life-threatening event that needs a proper understanding and good evaluation. A previous history of atopy or allergy to a certain agent increases the risk of allergy during anesthesia.

The mechanisms responsible for these allergic reactions include the humoral response of the immune system and the cellular response also is involved, anaphylaxis, classic and alternative pathway for complement activation and the anaphylactoid reactions are also involved.

The clinical manifestations of the allergic reactions include a wide range of symptoms of varying intensity from mild to fatal reactions in different patients. These manifestations are due to•release of mediators from mast cells and basophils the most important mediator is histamine which cause the cutaneous manifestations as urticaria and rash also hypotension which is due to transudation to extravascular space and venous pooling, hypotension is a very important sign as the presence of unexplained hpotension during the operation may suggest the beginning of anaphylactic reaction, the most serious complication is the respiratory complication which include bronchospasm and pulmonary edema which may lead to fatal arterial hypoxemia. Different• agents used during anesthesia are responsible for allergic reactions, these agents include muscle relaxants, intravenous anesthetics, local anesthetics, narcotics, radiocontrast media, protamine, latex, chymopapin, streptokinase, mannitol, methylmethacrylate, antibiotics, aspirin and insulin.