Accidents d’hypersensibilité per-anesthésiques : expérience d’un hôpital universitaire belge

Abstract

BackgroundAllergic peri-anaesthetic hypersensitivity reactions are rare but can have serious consequences. In Belgium, there are currently no published epidemiological papers on this subject. The aim of this paper is to describe the experience of a Belgian university hospital where patients were examined after suspected allergic peri-anaesthetic reaction. MethodsWe retrospectively analysed the medical files of 31 patients consulting the same allergist at the cliniques universitaires Saint-Luc in Brussels between 2012 and 2015 in a context of suspected peri-anaesthetic allergic reaction. Data were collected from the pre-anaesthesia and allergology consultation files as well as the anaesthesia reports and medico-surgical reports. ResultsTwenty-one patients (67.7%) developed an allergic peri-anesthetic hypersensitivity reaction to a substance used during anaesthesia. Most reactions (95%) were IgE-mediated and the majority were severe. The substances most frequently incriminated were rocuronium, cefazolin, latex and chlorhexidine. Cross-sensitivities were documented for neuromuscular blocking agents and cephalosporins. This work highlights certain dysfunctions that constitute a source of error in diagnosis. ConclusionThe results are similar to those of other studies. The diagnosis of peri-anaesthetic allergic hypersensitivity is difficult to establish for several reasons, and it is thus important to make as accurate a record as possible of the various indicators and ensure good communication with the allergy specialist, who must prepare an etymological report as early as possible.