Zusammenfassung
Im Rahmen eines operativen Eingriffs erhalten Patienten zahlreiche Arzneimittel. Entwickeln sie eine anaphylaktische Reaktion, so ist akut schwer zu beurteilen, welche Substanz für diese verantwortlich ist. Die meisten der intraoperativen Einschätzungen zur Ursache einer Anaphylaxie sind falsch. Umso wichtiger ist es, die verursachende Substanz später zu identifizieren, um eine Reexposition, z. B. bei einer erneuten OP, zu verhindern.
Abstract
The diagnostic evaluation of perioperative anaphylaxia is of great importance for the medical care of the affected persons in the context of renewed interventions in general anesthesia. The most frequent triggers include muscle relaxants, antibiotics, latex and analgesics of the type of the cyclooxygenase inhibitors, but other perioperatively administered drugs such as opioids, anesthetics, benzodiazepines, dyes, disinfectants and even corticosteroids or drug additives may also be the cause in rare cases. The most important aim is therefore the identification of the responsible drug, for which a near-time allergological diagnosis should be carried out within the first 4 weeks to 6 months after the reaction. At the end of the examinations, the patient receives a structured allergy passport, which includes information on the drug reaction, the triggers and alternative medicines, as well as possible preventive measures for future surgical procedures. It should be noted, however, that the latter are not a guarantee that, upon renewed exposure to the causative medicinal product, there will be no, possibly even heavier, anaphylactic reaction.
Schlüsselwörter
Allgemeinanästhesie - Anaphylaxie - Allergiepass - Arzneimittelallergie
Key words
anaphylaxia - general anesthesia - allergy passport - drug allergy
