Table 3.
Agents responsible for type I immediate allergic reactions during anesthesia [8]
| Agent |
Reaction (%) Francea |
Reaction (%) Australiab |
|---|---|---|
| Neuromuscular blocking drugs | 58.1 | 61.9 |
| Succinylcholine | 33.4 | 32.8 |
| Rocuronium | 29.3 | 16.8 |
| Atracurium | 19.3 | 9.1 |
| Vecuronium | 10.2 | 5.6 |
| Pancuronium | 3.6 | 1.9 |
| Mivacurium | 2.5 | 0.5 |
| Cisatracurium | 1.7 | 0.5 |
| Alcuroniumc | 24.8 | |
| d-Tubocurarine | 2.9 | |
| Gallamine | 2.1 | |
| More than one drugd | 2.1 | |
| Hypnotics/Induction agents | 2.3 | 10.4 |
| Propofol | 55.8 | 6.3 |
| Midazolam | 32.6 | |
| Thiopentone | 9.3 | 52.4 |
| Ketamine | 2.3 | |
| Alfathesin | 30.2 | |
| Propanidid | 9.5 | |
| Methohexitone | 1.6 | |
| Latex | 19.7 | 0.8 |
| Antibiotics | 12.9 | 8.6 |
| Penicillins | 49.0 | 15.4 |
| Cephalosporins | 37.0 | 73.1 |
| Vancomycin | 5.8 | |
| Others | 14.0 | 5.8 |
| Colloids | 3.4 | 4.6 |
| Gelatin | 89.9 | 85.7 |
| Hetastarch | 9.5 | |
| Albumin | 1.6 | |
| Dextran 70 | 14.3 | |
| Opioids | 1.7 | 2.6 |
| Morphine | 35.5 | 50.0 |
| Fentanyl | 22.6 | 25.0 |
| Sufentanil | 22.6 | |
| Nalbuphine | 12.9 | |
| Remifentanil | 6.5 | |
| Meperidine (Pethidine) | 18.7 | |
| Omnopon | 6.3 | |
| Other agentse,f | 2.7e | 3.8f |
| No causal drug detected | 7.4 |
From Baldo BA, Pham NH [2021]. Drug allergy: clinical aspects, mechanisms, diagnosis, structure-activity relationships. 2nd edition. Cham, Switzerland: Springer Nature. https://doi.org/10.1007/978-3-030-51740-3 [8]. Reproduced with permission from Springer Nature
aSurvey in France 1997-2004; 1816 patients. Data from Mertes PM, Alla F, Trechot P, et al. Aaphylaxis during anesthesia in France: an 8-year national survey. J Allergy Clin Immunol. 2011;128:366–73 [35]
bOn-going Australian survey; 606 patients. Data from Fisher MM, Jones K, Rose M. Follow-up after anaesthetic anaphylaxis. Acta Anaesthesiol Scand. 2011;55:99–103 [43]
cDiscontinued
dEight reactions with two different neuromuscular blocking drugs administered
eMade up largely of patent blue, propacetamol, local anesthetics, aprotinin and protamine
fMade up of largely of induction agent plus neuromuscular blocker (4 patients), protamine, local anesthetics, patent blue, chlorhexidine, contrast media and ondansetron