Integrating basophil activation tests into evaluation of perioperative anaphylaxis to neuromuscular blocking agents

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Threshold for basophil activation test positivity in neuromuscular blocking agents hypersensitivity reactions

BACKGROUND Several different criteria for the positivity of the flow-assisted Basophil Activation Test (BAT) for the diagnosis of Neuromuscular Blocking Agents (NMBA) hypersensitivity reactions have been used in past studies. Our aims were to determine the threshold for BAT positivity expressed as the stimulation index (SI, calculated as the percentage of activated basophils after stimulation w...

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Multiple cross-reactivity to several types of neuromuscular blocking agents in a patient with rocuronium anaphylaxis

provided the original work is properly cited. CC Anaphylaxis that occurs during anesthesia is a major cause of morbidity and mortality. Muscle relaxant is the most frequent cause of perioperative anaphylaxis [1]. Although it is believed that there is a risk of anaphylaxis to the drug in some patients, a similar incidence of anaphylaxis has been observed with use of other members of the same dru...

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Anaphylaxis to neuromuscular-blocking drugs: all neuromuscular-blocking drugs are not the same.

5 January 2015 I n the current issue of Anesthesiology, Reddy et al.1 report a two-hospital, retrospective, observational, cohort study confirming that anaphylaxis is more common with rocuronium and succinylcholine than with atracurium, a topic that is difficult to assess and was first highlighted in this journal in 2003.2 Although any medication can potentially cause perioperative anaphylaxis,...

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Neuromuscular Blocking Agents

• Neuromuscular blocking agents are used to improve conditions for tracheal intubation, to provide immobility during surgery, and to facilitate mechanical ventilation. • The main site of action of neuromuscular blocking agents (muscle relaxants) is on the nicotinic cholinergic receptor at the endplate of muscle. They also have effects at presynaptic receptors located on the nerve terminal. • Su...

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Rocuronium anaphylaxis in a 3-year-old girl with no previous exposure to neuromuscular blocking agents.

During the perioperative period, anaphylactic reactions rarely occur. Neuromuscular blocking agents (NMBAs) are responsible for 60-70% of perioperative anaphylactic reactions. This case, we report a case of rocuronium-induced anaphylaxis in a 3-year-old girl with no previous exposure to NMBAs. This case cautions and informs practitioners that an IgE-mediated anaphylactic reaction with rocuroniu...

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ژورنال

عنوان ژورنال: British Journal of Anaesthesia

سال: 2019

ISSN: 0007-0912

DOI: 10.1016/j.bja.2019.02.024