Table of ContentsView AllTable of ContentsAllergensSymptomsTreatmentOther ReactionsRisk Reduction
Table of ContentsView All
View All
Table of Contents
Allergens
Symptoms
Treatment
Other Reactions
Risk Reduction
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Most Common Allergens in Surgery
Any medication or substance used perioperatively, or during surgery, can trigger an allergic reaction—not just those involved in anesthesia. The following surgical agents are the most common cause of anaphylaxis, a life-threatening allergic reaction, during surgery:
True anaphylaxis during surgery is rare, occurring in approximately one in every 20,000 people. The risk is highest in those who have never undergone a procedure with general anesthesia before, as these individuals may not be aware of their allergy.
Perioperative Allergy Symptoms
Perioperative allergic reactions often manifest abruptly with severe symptoms.Some of the most common perioperative allergic reaction symptoms include:
The most severe and deadly form of anesthesia allergy is calledanaphylaxis. Symptoms of perioperative anaphylaxis can include:
Additionally, other common anaphylaxis symptoms, like hives and flushing, may not appear. In fact, up to 20% of people experiencing perioperative anaphylaxis show only a drop in blood pressure or cardiovascular collapse.
How It’s Treated
For mild to moderate symptoms, a small amount of epinephrine is given intravenously. If the patient’s blood pressure drops severely, a higher dose of epinephrine is used to help stabilize them.
To support the patient’s breathing and heart function, 100% oxygen is given, and fluids are administered through an IV. If the airways swell, epinephrine and other medications likecorticosteroidsare used to reduce the swelling.
If there is difficulty breathing due tobronchospasm, which occurs when the muscles around the airways tighten and make it harder to breathe, bronchodilators and corticosteroids are given to open up the airways.
After the allergic reaction is treated, confirmatory tests are important to find out what caused the reaction. Blood tests to check mast cell tryptase levels help doctors understand if it was truly anaphylaxis. Skin testing is done later to identify the specific allergen, which helps prevent future reactions.
Nonallergic Reactions to Anesthesia
Anesthesia can cause unpleasant and occasionally serious side effects. It’s essential to understand that those side effects are not the same as an allergic reaction.
Allergic reactions happen when your body’s immune system overreacts to a substance, while side effects are unwanted effects that are not related to the immune system.
General Side Effects
General side effects of anesthesia are temporary and usually resolve within 24 hours. Potential side effects of anesthesia include:
Malignant Hyperthermia
Immediate treatment and discontinuation of anesthetic medication for malignant hyperthermia is essential. When a person has malignant hyperthermia, their body can react in several ways, including:
Pseudocholinesterase Deficiency
Pseudocholinesterase deficiencyis a condition causing a patient to be very sensitive to certain muscle relaxant medications used in anesthesia.
Muscle relaxants, orneuromuscular blocking agents(NMBAs), are medications commonly used to keep patients still and calm during medical procedures.This type of anesthetic is most commonly used duringintubationandmechanical ventilation.
Under normal circumstances, the medications are broken down very quickly, usually within a few minutes. But with pseudocholinesterase deficiency, patients don’t metabolize the medication for a much longer time, sometimes even for several hours.
Muscle relaxants also cause thediaphragm, a thin skeletal muscle at the base of the chest, to relax and make it difficult for people to breathe independently. These patients may require mechanical ventilation to help them breathe until the drugs have metabolized.
Reducing Your Risk of an Allergic Reaction
If you have a personal or family history of allergies or anaphylaxis, talk to your provider about anesthesia allergy risks. A history of allergies puts you at a higher risk of allergy to medications used for anesthesia during medical procedures.
Identifying risks before surgery will help your provider plan accordingly and be alert to potential allergic reactions. If you have ever had a heart attack or other serious reaction to anesthesia during or after a procedure, be sure to inform your healthcare provider well before receiving anesthesia again.
Summary
Anesthesia is a medical treatment using drugs to prevent a patient from feeling pain during a medical procedure like surgery. Allergic reactions to anesthetics can occur, though they are very rare. Some of the most common allergic reactions to anesthetics are skin rash, itching, and swelling of the face, tongue, or lips. Anaphylactic shock is possible and requires immediate medical attention.
Identifying risks before surgery will help your healthcare provider plan accordingly, so be sure to inform them of any allergies or previous reactions to anesthesia.
5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Admass B, Hassen A, Agegnehu A, et al.Management of perioperative anaphylaxis: systematic review.Int J Surg Open. 2023 Mar;52(1):100595. doi:10.1016/j.ijso.2023.100595Bevanda D, Čačić M, Mihaljević S, Bevanda M, Bogut A, Karin M.Allergic reactions and anesthesia.Psychiatr Danub. 2017 Dec;29(4):778-786.Schroeder M, Kraft C, Janis J, Kraft M.Diagnosis and treatment of perioperative allergic complications: a practical review.Plast Reconstr Surg Glob Open. 2024 Apr;12(4):e5734. doi:10.1097/GOX.0000000000005734American Society of Anesthesiologists.Effect of anesthesia.MedlinePlus.Pseudocholinesterase deficiency.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Admass B, Hassen A, Agegnehu A, et al.Management of perioperative anaphylaxis: systematic review.Int J Surg Open. 2023 Mar;52(1):100595. doi:10.1016/j.ijso.2023.100595Bevanda D, Čačić M, Mihaljević S, Bevanda M, Bogut A, Karin M.Allergic reactions and anesthesia.Psychiatr Danub. 2017 Dec;29(4):778-786.Schroeder M, Kraft C, Janis J, Kraft M.Diagnosis and treatment of perioperative allergic complications: a practical review.Plast Reconstr Surg Glob Open. 2024 Apr;12(4):e5734. doi:10.1097/GOX.0000000000005734American Society of Anesthesiologists.Effect of anesthesia.MedlinePlus.Pseudocholinesterase deficiency.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Admass B, Hassen A, Agegnehu A, et al.Management of perioperative anaphylaxis: systematic review.Int J Surg Open. 2023 Mar;52(1):100595. doi:10.1016/j.ijso.2023.100595Bevanda D, Čačić M, Mihaljević S, Bevanda M, Bogut A, Karin M.Allergic reactions and anesthesia.Psychiatr Danub. 2017 Dec;29(4):778-786.Schroeder M, Kraft C, Janis J, Kraft M.Diagnosis and treatment of perioperative allergic complications: a practical review.Plast Reconstr Surg Glob Open. 2024 Apr;12(4):e5734. doi:10.1097/GOX.0000000000005734American Society of Anesthesiologists.Effect of anesthesia.MedlinePlus.Pseudocholinesterase deficiency.
Admass B, Hassen A, Agegnehu A, et al.Management of perioperative anaphylaxis: systematic review.Int J Surg Open. 2023 Mar;52(1):100595. doi:10.1016/j.ijso.2023.100595
Bevanda D, Čačić M, Mihaljević S, Bevanda M, Bogut A, Karin M.Allergic reactions and anesthesia.Psychiatr Danub. 2017 Dec;29(4):778-786.
Schroeder M, Kraft C, Janis J, Kraft M.Diagnosis and treatment of perioperative allergic complications: a practical review.Plast Reconstr Surg Glob Open. 2024 Apr;12(4):e5734. doi:10.1097/GOX.0000000000005734
American Society of Anesthesiologists.Effect of anesthesia.
MedlinePlus.Pseudocholinesterase deficiency.
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