TY - JOUR TI - Anaphylaxis during anesthesia in France: an 8-year national survey AU - Mertes, Paul Michel AU - Alla, François AU - Tréchot, Philippe AU - Auroy, Yves AU - Jougla, Eric AU - Groupe d'Etudes des Réactions Anaphylactoïdes Peranesthésiques T2 - The Journal of allergy and clinical immunology AB - BACKGROUND: More attention should be paid to rare serious adverse events such as anaphylaxis to increase the safety of anesthesia. OBJECTIVE: To report the results of an 8-year survey of anaphylaxis during anesthesia in France. METHODS: Data from patients who experienced anaphylaxis between January 1, 1997, and December 31, 2004, were analyzed. Estimated incidences were obtained by combining this database with data from the French pharmacovigilance system by using a capture-recapture method. The number of patients exposed to the offending agents was obtained from data collected during the national survey of anesthesia practice. RESULTS: A total of 2516 patients was included. A diagnosis of IgE-mediated reaction was established in 1816 cases (72.18%). The most common causes were neuromuscular blocking agents ([NMBAs]; n = 1067; 58.08%), latex (n = 361; 19.65%), and antibiotics (n = 236; 12.85%). The median annual incidence per million procedures was higher for females 154.9 (5th-95th percentile, 117.2-193.1) than for males 55.4 (5th-95th percentile, 42.0-68.0). It reached 250.9 (5th-95th percentile, 189.8-312.9) for women in cases of allergic reactions to NMBAs. In children, a diagnosis of IgE-mediated reactions was obtained in 122 cases (45.9%). The most common causes were latex (n = 51; 41.8%), NMBAs (n = 39; 31.97%), and antibiotics (n = 11; 9.02%). In contrast with adults, no female predominance was observed. CONCLUSION: The incidence of allergic reactions during anesthesia, estimated on a national basis, is higher than previously estimated. These results should be taken into account in the evaluation of the benefit-to-risk ratio of the various anesthetic techniques in individuals. The similar incidence of reactions according to sex before adolescence suggests a role for sex hormones in the increase of anaphylaxis observed in women. DA - 2011/08// PY - 2011 DO - 10.1016/j.jaci.2011.03.003 DP - NCBI PubMed VL - 128 IS - 2 SP - 366 EP - 373 J2 - J. Allergy Clin. Immunol. LA - eng SN - 1097-6825 ST - Anaphylaxis during anesthesia in France KW - Adolescent KW - Adult KW - Anaphylaxis KW - Anesthesia KW - Anesthetics KW - Anti-Bacterial Agents KW - Child KW - Child, Preschool KW - Female KW - France KW - Health Surveys KW - Humans KW - Immunoglobulin E KW - Incidence KW - Male KW - Neuromuscular Blocking Agents KW - Sex Distribution KW - Sex Factors ER -