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Original Article


Reducing the risk of anaphylaxis during anaesthesia: guidelines for clinical practice


P.M. Mertes1, M.C. Laxenaire1, A. Lienhart2, and the working group for the SFAR* and W. Aberer3, J. Ring4, W.J. Pichler5, P. Demoly6, for ENDA** and the EAACI interest group on drug hypersensitivity

1Service d’Anesthésie-Réanimation Chirurgicale, Nancy, France;
2Département d’Anesthésie-Réanimation, Hôpital Saint-Antoine, Paris, France;
3Department of Environmental Dermatology, Graz, Austria;
4Klinik und Poliklinik für Dermatologie und Allergologie, Muenchen, Germany;
5Clinic for Rheumatology and Clinical Immunology/Allergy, Inselspital, Bern, Switzerland;
6Exploration des Allergies -Maladies Respiratoires -INSERM U454, Hôpital Arnaud de Villeneuve, Montpellier, France.
* SFAR: Société Française d’Anesthésie et de Réanimation with the following additional members in the working group: G. Decroix, P. Dewachter, J.L. Guéant, L. Guilloux, D. Laroche, F. Leynadier, D. Longrois, J.M. Malinovsky, D.A. Moneret-Vautrin, C. Pecquet, M. Pinaud, P. Tréchot, D. Vervloet, F. Wessel
** ENDA: European Network for Drug Allergy and the EAACI interest group on drug hypersensitivity with the following additional members in the working group: B.K. Ballmer-Weber, A. Barbaud, B. Bilo, J. Birnbaum, M. Blanca, B. Blömecke, K. Brockow, C. Christiansen, A. de Weck, C. Dzviga, M. Drouet, B. Eberlein-König, A.T. Frew, T. Fuchs, J.L. Guéant, R. M. Guéant-Rodríguez, C. Gutgesell, M. Hertl, G. Kanny, A. Kapp, M. Kidon, M. Kowalski, G. Marone, H. Merk, D.A. Moneret-Vautrin, C. Pascual-Marcos, B. Przybilla, E. Rebelo-Gomes, F. Rueff, A. Sabbah, J. Sainte Laudy, M. L. Sanz, E. Tas, A. Romano, M.J. Torres, D. Vervloet, B. Wedi, B. Wüthrich

J Invest Allergol Clin Immunol 2005; Vol. 15(2): 91-101



Summary: These guidelines represent a consensus of experts in the field of immediate hypersensitivity reactions occurring during anaesthesia. They were based on international science, and implemented in France under the auspices of the French Society for Anaesthesia and Intensive Care (SFAR: Société Française d’Anesthésie et de
Réanimation). Their aim was to provide the most valid, widely accepted, effective and easily teachable guidelines that current knowledge, research and experience can provide. This paper presents the main extracts of these recommendations with the most relevant clinical implications.

Key Words
: anaphylaxis, anaesthesia, histamine, hypersensitivity, IgE, neuromuscular blocking agents, hypnotics, latex, skin tests, tryptase.