Table 1.

Clinical backgrounds, causative agents, timing and onset of the appearance of symptoms, anaphylactic symptoms, severity grades, clinical scores, and outcomes in patients with perioperative anaphylaxis

Patient no.	Age (years)	Sex	Causative agent	Timing	Onset (min)	Symptoms	Severity grade	Clinical score	Cancelled operation	Delayed extubation
1	75	F	Sugammadex	End	3	Ca, Cu	3	25	−	+
2	34	M	Sugammadex	End	1	Ca, Cu	2	19	−	−
3	13	M	Sugammadex	End	5	Ca, Cu, Re	3	30	−	+
4	65	M	Sugammadex	End	< 1	Ca, Cu, Re	3	27	−	+
5	39	M	Sugammadex	End	8	Ca, Cu	2	17	−	−
6	62	M	Sugammadex	End	3	Ca, Ga	3	13	−	−
7	64	F	Sugammadex	End	3	Ca, Cu	2	21	−	+
8	33	F	Sugammadex	End	5	Ca, Cu	2	19	−	−
9	46	F	Sugammadex	End	3	Ca, Cu, Re	3	30	−	+
10	66	M	Sugammadex	End	3	Ca, Cu, Re	3	28	−	−
11	19	F	Sugammadex	End	3	Ca, Cu, Re	3	30	−	+
12	42	F	Sugammadex	End	3	Ca, Cu, Ga	3	15	−	−
13	55	M	Sugammadex	End	3	Ca, Cu	3	17	−	−
14	41	F	Rocuronium	Induction	< 1	Ca, Re	4	35	+	−
15	52	F	Rocuronium	Induction	5	Ca, Cu, Re	3	28	−	−
16	56	F	Rocuronium	Induction	5	Ca, Re	2	22	−	+
17	74	F	Rocuronium	Maintenance	20	Ca, Cu	3	11	−	−
18	16	M	Rocuronium	Induction	5	Ca, Cu	3	23	+	−
19	72	M	Rocuronium	Induction	3	Ca	3	17	+	−
20	38	F	Rocuronium	Induction	3	Ca, Cu, Re	2	22	+	+
21	83	F	Rocuronium	Induction	10	Ca, Cu	2	17	+	−
22	78	F	Rocuronium	Induction	10	Ca, Cu, Re	2	19	−	−
23	36	M	Rocuronium	Induction	3	Ca, Cu, Re	2	28	+	−
24	71	F	Cefazolin	Maintenance	10	Ca, Cu	3	21	+	+
25	26	F	Cefazolin	Maintenance	2	Ca, Re	3	26	+	+
26	67	F	Cefazolin	Maintenance	3	Ca, Cu	2	21	−	−
27	7	F	Cefazolin	Maintenance	10	Ca, Re	3	22	+	−
28	33	F	Cefazolin	Maintenance	20	Ca, Cu	3	12	−	−
29	77	M	Cefazolin	Maintenance	10	Ca, Cu, Re	3	20	−	−
30	51	M	Cefazolin	Maintenance	10	Ca, Cu	3	19	+	−
31	14	M	Cefazolin	Maintenance	10	Ca, Cu	2	24	−	−
32	56	M	Cefoperazone/Sulbactam	Maintenance	5	Ca, Re	4	32	−	+
33	49	F	Cefmetazole	Maintenance	5	Ca, Cu	3	23	−	−
34	36	F	Cefmetazole	Maintenance	5	Ca, Cu	2	17	−	−
35	77	M	Vancomycin	Maintenance	5	Ca, Cu	4	28	−	−
36	86	M	Ceftriaxone	Maintenance	5	Ca, Cu	3	23	+	−
37	44	F	Cefotiam	Maintenance	10	Ca, Cu	3	19	+	−
38	25	M	Fosfomycin	Maintenance	5	Ca, Cu, Re	3	18	+	−
39	54	M	Lidocaine	Induction	< 1	Ca, Cu	3	12	−	−
40	42	F	Mepivacaine	Induction	10	Ca, Cu	3	13	−	−
41	21	M	Flurbiprofen	End	10	Ca, Cu	2	20	−	−
42	61	F	Propofol	Induction	< 1	Cu, Re	2	17	−	−
43	66	M	Fibrin sealant	Maintenance	5	Ca, Cu	3	13	−	−
44	49	F	Fibrin sealant	Maintenance	10	Ca, Cu	2	9	−	−
45	80	F	Atropine	Induction	3	Ca, Cu	2	13	−	−
46	50	M	Iopamidol	Maintenance	10	Ca	3	9	−	−

The timing of symptom appearance was classified into three categories, including induction, maintenance, and end of anesthesia. The induction of anesthesia refers to within 10 min after the start of anesthesia. The end of anesthesia means from the end of surgery to the end of anesthesia. Maintenance of anesthesia is the period between induction of anesthesia and the end of anesthesia. The onset indicates time from drug administration to the appearance of the first symptom. The severity of clinical symptoms was assessed by the Ring and Messmer scale [15]. All patients had a clinical score of 8 or above, suggesting possible anaphylaxis [9]. Delayed extubation was defined as when the patient was extubated after leaving the operating room, or when it took more than two hours from the end of surgery to extubation even in the operating room

M male, F female, Ca cardiovascular signs, Cu cutaneous signs, Re respiratory signs, Ga gastrointestinal signs