Table 2.
Characteristics of perioperative anaphylaxis classified by causative agent
| Sugammadex | Rocuronium | Cefazolin | Antibiotics | Miscellaneous | All | |
|---|---|---|---|---|---|---|
| Number of patients (%) | 13 (28.3) | 10 (21.7) | 8 (17.4) | 7 (15.2) | 8 (17.4) | 46 (100.0) |
| Background | ||||||
| Female (%) | 6 (46.2) | 7 (70.0) | 5 (62.5) | 3 (42.9) | 4 (50.0) | 25 (54.3) |
| Male (%) | 7 (53.8) | 3 (30.0) | 3 (37.5) | 4 (57.1) | 4 (50.0) | 21 (45.7) |
| Age (years) | 47.2 (19.2) | 54.6 (22.0) | 43.3 (27.0) | 53.3 (21.8) | 52.9 (17.5) | 50.0 (20.9) |
| Timing | ||||||
| Induction (%) | 0 (0.0) | 9 (90.0)a | 0 (0.0) | 0 (0.0) | 4 (50.0) | 13 (28.3) |
| Maintenance (%) | 0 (0.0) | 1 (10.0) | 8 (100.0)b | 7 (100.0)c | 3 (37.5) | 19 (41.3) |
| End (%) | 13 (100.0)d | 0 (0.0) | 0 (0.0) | 0 (0.0) | 1 (12.5) | 14 (30.4) |
| Onset (min) | 3.0 (1.0) | 5.0 (7.0) | 10.0 (5.3)e | 5.0 (0.0) | 7.5 (8.5) | 5.0 (7.0) |
| Symptom | ||||||
| Cardiovascular (%) | 13 (100.0) | 10 (100.0) | 8 (100.0) | 7 (100.0) | 7 (87.5) | 45 (97.8) |
| Respiratory (%) | 5 (38.5) | 6 (60.0) | 3 (37.5) | 2 (28.6) | 1 (12.5) | 17 (37.0) |
| Cutaneous (%) | 12 (92.3) | 7 (70.0) | 6 (75.0) | 6 (85.7) | 7 (87.5) | 38 (82.6) |
| Gastrointestinal (%) | 2 (15.4) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 2 (4.3) |
| Clinical score | 22.4 (6.2) | 22.2 (6.8) | 20.6 (4.1) | 22.9 (5.5) | 13.3 (3.7)f | 20.5 (6.4) |
| Severity grade | 3.0 (1.0) | 2.5 (1.0) | 3.0 (0.8) | 3.0 (1.0) | 2.5 (1.0) | 3.0 (1.0) |
| Outcome | ||||||
| Cancelled operation (%) | 0 (0.0) | 6 (60.0)g | 4 (50.0) | 3 (42.9) | 0 (0.0) | 13 (28.3) |
| Delayed extubation (%) | 6 (46.2) | 2 (20.0) | 2 (25.0) | 1 (14.3) | 0 (0.0) | 11 (23.9) |
“Antibiotics” refers to antibiotics other than cefazolin. Categorical variables are shown as the actual numbers, and percentages are shown in parentheses. Since age and clinical score were normally distributed, they are shown as means, and standard deviations are shown in square brackets. For onset and severity grade, the median values and interquartile ranges are shown. 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 the time from drug administration to the appearance of the first sign. The accuracy of anaphylaxis diagnosis was assessed using the clinical grading scale [9]. The severity of clinical signs was assessed by the Ring and Messmer scale [15]. 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. The symbols indicate significant differences between groups, and p values were 0.005 or less unless otherwise specified
aRocuronium vs. sugammadex, cefazolin, and antibiotics; bCefazolin vs. rocuronium and sugammadex
cAntibiotics vs. rocuronium and sugammadex
dSugammadex vs. all other groups
eCefazolin vs. sugammadex (p < 0.05)
fMiscellaneous vs. sugammadex, rocuronium, cefazolin, and antibiotics (p < 0.05)
gRocuronium vs. sugammadex (p < 0.05)