• Perioperative anaphylaxis.

      Mertes, P M; Tajima, K; Regnier-Kimmoun, M A; Lambert, M; Iohom, G; Guéant-Rodriguez, R M; Malinovsky, J M; Service d'Anesthésie-Réanimation Chirurgicale, CHU de Nancy, Hôpital Central, 29 Avenue de Lattre de Tassigny, 54035 Nancy Cedex, France. pm.mertes@chu-nancy.fr (Elsevier, 2010-07)
      The incidence of immune-mediated anaphylaxis during anesthesia ranges from 1 in 10,000 to 1 in 20,000. Neuromuscular blocking agents are most frequently incriminated, followed by latex and antibiotics, although any drug or substance used may be a culprit. Diagnosis relies on tryptase measurements at the time of the reaction and skin tests, specific immunoglobulin E, or basophil activation assays. Treatment consists of rapid volume expansion and epinephrine administration titrated to symptom severity.