Perioperative medicine & outcomes
The Japanese Epidemiologic Study for Perioperative Anaphylaxis, a prospective nationwide study: allergen exposure, epidemiology, and diagnosis of anaphylaxis during general anaesthesia
Authors' conclusion
We developed a composite tool to diagnose anaphylaxis, and found that the combination of tryptase levels, skin testing, and basophil activation testing results and clinical score improved the certainty of anaphylaxis diagnosis. The incidence of perioperative anaphylaxis in our study was 1 in about 5000 general anaesthesia cases.
Study context
- Population
- Patients with anaphylaxis of Grade 2 or higher severity during GA at 42 facilities across Japan in 2019 and 2020
- Participants
- 218,936 GA cases
- Outcome
- Frequency of anaphylaxis with each drug during the perioperative period
Methodological detailsmulticentre, Composite score for diagnosing anaphylaxis including skin tests, basophil activation tests and clinical scores
- Multicentre
- Composite score for diagnosing anaphylaxis including skin tests, basophil activation tests and clinical scores
Main finding
As reported in the abstract
Perioperative anaphylaxis cases and causative agents
- Patients with suspected perioperative anaphylaxis
- 55
- High probability of anaphylaxis by composite score
- 43
- Causative agent identified
- 32
- Rocuronium: 10 cases in 210 852 patients
- 0.005%
- Sugammadex: 7 cases in 150 629 patients
- 0.005%
- Cefazolin: 7 cases in 106 005 patients
- 0.007%
Observational data: associations, not effects.
Further findings
- Plasma histamine levels showed high diagnostic accuracy for anaphylaxis
Original publication
The Japanese Epidemiologic Study for Perioperative Anaphylaxis, a prospective nationwide study: allergen exposure, epidemiology, and diagnosis of anaphylaxis during general anaesthesia. Br J Anaesth. Published 27 March 2023. doi:10.
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