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Reducing the Risk of Anaphylaxis During Anesthesia: 2011 Updated Guidelines for Clinical Practice


PM Mertes,1 JM Malinovsky,2 L Jouffroy,3 and the Working Group of the SFAR* and SFA* and W Aberer,4 I Terreehorst,5 K Brockow,6 P Demoly,7 for ENDA** and the EAACI Interest Group on Drug Allergy

1Service d’Anesthésie-Réanimation Chirurgicale - Inserm U911, CHU de Nancy, Hôpital Central, Nancy, France
2Département d’Anesthésie-Réanimation, Hôpital Maison Blanche, Reims, France
3Société Française d’Anesthésie et de Réanimation, Paris, France
4Department of Environmental Dermatology and Allergy, University of Graz, Graz, Austria
5Department of ENT and Department of Pediatrics, AMC Hospital, Amsterdam, The Netherlands
6Department of Dermatology and Allergology Biederstein, Technische Universität München, Munich, Germany
7Allergy Department - Inserm U657, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, France
*SFAR (Société Française d’Anesthésie et de Réanimation) and SFA (Société Française d’Allergologie) with the following additional members in the working group: F Bérard, M Bruyere, I Constant, B Debaene, M Drouet, C Karila, F Lavaud, C Lejus, D Longrois, MM Lucas, A Magnan, DA Moneret-Vautrin, C Mouton, B Plaud, and C Ponvert.
**ENDA (European Network for Drug Allergy) and the EAACI interest group on drug hypersensitivity with the following additional members: S Bavbek (Turkey), B Bilo (Italy), PJ Bousquet (France), J Cernadas (Portugal), LH Garvey (Denmark), H Gooi (UK), E Gomes (Portugal), ML Kowalski (Poland), V Kvedariene (Lithuania), H Mosbech, WJ Pichler (Switzerland), A Romano (Italy), R Sargur (UK), M Sanz (Spain), F Saretta (Italy), and A Trautman

J Investig Allergol Clin Immunol 2011; Vol. 21(6): 442-453



These guidelines represent the updated consensus of experts in the field of immediate hypersensitivity reactions occurring during anesthesia.
They provide a series of valid, widely accepted, effective, and easily teachable guidelines that are the fruit of current knowledge, research, and experience. The guidelines are based on the findings of international scientific research and have been implemented in France under the auspices of the French Society for Anaesthesia and Intensive Care (Société Française d’Anesthésie et de Réanimation [SFAR]) and the French Society of Allergology (Société Française d’Allergologie [SFA]). The members of the European Network for Drug Allergy approved the guidelines. This paper presents the most relevant clinical implications of the guidelines.

Key words: Anaphylaxis. Anesthesia. Histamine. Hypersensitivity. IgE. Neuromuscular blocking agents. Hypnotics. Latex. Skin tests. Tryptase.