Journal article outlines difficulties that allergists and immunologists face in assessing patients for potential of rare perioperative anaphylaxis

An article in press published this month in Annals of Allergy, Asthma, & Immunology, the official journal of the American College of Allergy, Asthma and Immunology, examines the challenges of perioperative anaphylaxis.

The article is authored by Dennis K. Ledford, MD, FAAAAI, FACAAI, Mabel and Ellsworth Simmons Professor of Allergy/Immunology of the University of South Florida’s Morsani College of Medicine, and section chief, allergy/immunology at James A. Haley VA Hospital.

Dr. Ledford notes that perioperative anaphylaxis is rare, with approximately 1:10,000 anesthetic events in adults and 1:35,000 in children—but providers need to be prepared for those rare occurrences. He notes other factors beyond rarity of occurrence that can make it difficult for allergists and immunologists to assess patients for potential of perioperative anaphylaxis, including:

• numerous other possible explanations for hypotension or respiratory symptoms during anesthesia
• limitations of drug allergy testing
• the multiple drugs and agents used in anesthesia and surgery
• communication issues among anesthesia, surgical teams and outpatient specialists
• unfamiliarity of allergists/immunologists with many medications used during anesthesia
• difficulties in acquiring anesthetic drugs for testing
• time pressures due to the need to complete surgical procedures

Dr. Ledford summarizes recent literature on perioperative anaphylaxis and provides guidance. Access his full article here.