Anaphylaxis during anesthesia in adults and children
More attention should be paid to rare serious adverse events such as anaphylaxis to increase the safety of anesthesia. Despite systematic efforts aimed at characterizing the epidemiology of these reactions, they remain poorly defined.
In their report, published in the April 2011 issue of The Journal of Allergy and Clinical Immunology (JACI), Mertes et al, provide a nationally based estimate of the incidence of immediate IgE-mediated allergic reactions occurring during anesthesia, depending on gender, age, and causal substance, using a combined analysis of three different databases. They confirm the general view that these reactions are largely underreported, with a higher incidence (100.6 [76.2-125.3] / million procedures) of allergic reactions than previously thought, adult females being at significantly higher risk than males.
In addition, their study highlights for the first time the specificities of allergic reactions in children. The similar incidence of allergic and non-allergic reactions in males and females before adolescence strongly suggests a role for sex hormones in the increase of immediate hypersensitivity reactions observed in adult females. These results should be taken into account when evaluating the benefit-to-risk ratio of various anesthesia techniques in the different subsets of the population.
The Journal of Allergy and Clinical Immunology (JACI) is the official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.