thiopental and Anaphylaxis

Topics: Adult; Alfaxalone Alfadolone Mixture; Anaphylaxis; Anesthesia; Anesthetics; Animals; Complement Activation; Complement System Proteins; Dogs; Humans; Leukocytes; Platelet Aggregation; Thiopental

Severe histamine mediated reactions to intravenous drugs used in anaesthesia may occur as a result of anaphylactic and anaphylactoid reactions. The incidence is rare, but appears to be increasing. The difficulties in diagnosing such reactions and in determining the drug responsible and how these difficulties have led to confusion in the literature are discussed. Six cases of severe histamine mediated reactions are presented and detailed analyses of the drugs in these and other reported reactions is made showing varied clinical patterns with different drugs. The prevention, treatment, and follow-up of severe histamine mediated reactions are considered.

Topics: Adolescent; Adult; Alfaxalone Alfadolone Mixture; Anaphylaxis; Anesthesia, Intravenous; Anesthetics; Antigen-Antibody Reactions; Drug Hypersensitivity; False Negative Reactions; False Positive Reactions; Female; Histamine H1 Antagonists; Histamine Release; Humans; Male; Neuromuscular Nondepolarizing Agents; Propanidid; Skin Tests; Succinylcholine; Thiopental

In the perioperative setting multiple agents can cause anaphylaxis. Often the reactions are dramatic, and due to their lifethreatening potential it is crucial that the responsible agent is identified in order to avoid future adverse reactions. The aim of the present study was to measure the concentration of serum mast cell tryptase (MCT), to investigate the prevalence of serum IgE antibodies against ammonium groups, choline, morphine, suxamethonium, thiopentone and latex and to perform skin prick tests (SPTs) in 18 patients experiencing an anaphylactic reaction during induction of general anaesthesia.. Serum samples from 18 patients with an anaphylactic reaction during general anaesthesia were analyzed for MCT and specific IgE against ammonium groups, choline, morphine, suxamethonium, thiopentone and latex. Skin prick tests were performed in 11 out of 18 patients.. Ten patients had elevated MCT levels and specific IgE against ammonium ion, morphine and (with the exception of patient nos 3, 9 and 10) suxamethonium. Seven of these patients had positive SPTs to suxamethonium. One of the patients tested positive to latex in addition to suxamethonium. Two patients showed elevated MCT, while specific IgE against the drugs tested was not detected. Three patients tested positive to ammonium ion, morphine and suxamethonium, but negative to MCT. Three patients tested negative to both MCT and specific IgE.. Fifteen out of 18 sera tested positive for MCT and/or specific IgE against neuromuscular blocking drugs (NMBDs). Ten of the 18 patients experienced an IgE-mediated anaphylactic reaction to NMBDs during anaesthesia, verified by detection of specific IgE and elevated levels of MCT.

Topics: Adult; Analgesics, Opioid; Anaphylaxis; Anesthesia, General; Anesthetics, Intravenous; Biomarkers; Choline; Drug Hypersensitivity; Female; Humans; Immunoglobulin E; Latex; Male; Mast Cells; Morphine; Neuromuscular Blocking Agents; Neuromuscular Depolarizing Agents; Quaternary Ammonium Compounds; Serine Endopeptidases; Skin Tests; Succinylcholine; Thiopental; Tryptases

A 6-year-old boy presented for surgery for phimosis. The anaesthetic technique included intravenous induction with thiopentone and neuromuscular blockade with cisatracurium. Severe persistent bronchospasm and central cyanosis followed the administration of these drugs. A continuous i.v. infusion of epinephrine at 0.2 microg. kg(-1) x min(-1) was necessary to break the severe refractory bronchial hyperresponsiveness. There was no previous exposure to anaesthetic drugs and no definite family history of allergy. Through increased serum eosinophil cationic protein, tryptase and histamine levels and IgE levels specific to cisatracurium, we demonstrated an IgE-mediated anaphylactic reaction to cisatracurium in the child's first exposure to this new neuromuscular blocking agent. Anaphylactic reactions to new anaesthetic drugs may be challenging to recognize and treat during general anaesthesia in children. The pathogenesis, diagnosis and management of life threatening persistent allergic reactions to intravenous anaesthetics are discussed.

Topics: Adrenergic Agonists; Anaphylaxis; Anesthetics, Intravenous; Atracurium; Blood Proteins; Bronchial Hyperreactivity; Bronchial Spasm; Child; Chymases; Cyanosis; Eosinophil Granule Proteins; Epinephrine; Histamine; Humans; Immunoglobulin E; Inflammation Mediators; Male; Mast Cells; Neuromuscular Blockade; Neuromuscular Blocking Agents; Phimosis; Ribonucleases; Serine Endopeptidases; Thiopental; Tryptases

During general anesthesia adverse reactions are not uncommon, and the hypothesis of an anaphylactic response cannot be excluded. In these situations, a differential diagnosis from other events which often present identical clinical manifestations is necessary. For this purpose measurement of serum tryptase, as a biochemical marker of the release of mast-cell granules, is considered a valuable and specific method, especially if it is carried out on several hematic samples, obtained in successive times, for pointing out the progressive reduction of the values. If an anapyhlactic pathogenesis is confirmed, the identification of the responsible drug is necessary for a safer approach of the patient in view of a further anesthesia. A severe and protracted reaction has been observed after a standard induction of anesthesia, in which measurement of serum tryptase has shown high values of this protease 2 hours after the reaction which a subsequent decrease in the samples repeated after 5, 8, 11 e 20 hours, suggesting an anaphylactic etiology of the reaction. The specific RAST for the substances employed has excluded a role for muscle relaxant, plasma expander and latex, while it was positive for tiopenthal, suggesting in this case a true anaphylactic reaction caused by the hypnotic drug.

Topics: Aged; Anaphylaxis; Anesthesia, General; Anesthetics, Intravenous; Chymases; Clinical Enzyme Tests; Humans; Immunoglobulin E; Male; Radioallergosorbent Test; Serine Endopeptidases; Thiopental; Tryptases

Topics: Aged; Anaphylaxis; Anesthesia, Intravenous; Anesthetics, Intravenous; Bronchial Spasm; Humans; Hypotension; Male; Neuromuscular Nondepolarizing Agents; Pancuronium; Propofol; Tachycardia; Thiopental

Although allergenic cross-reactivity of neuromuscular blocking drugs (NMBDs) is recognised clinically and has been firmly established at the serological and immunochemical levels, interpretation of in vitro inhibition findings for clinical purposes is not always straightforward. Points to be taken into account when considering serum IgE direct binding and inhibition results and when determining which NMBDs a patient may be sensitive to, include the relationship between in vitro potencies and clinical findings and the nature of the drug solid phase used for testing. It should also be remembered that the stimulating antigenic source for the patients' NMBD-reactive IgE antibodies is almost always unknown. A comparison of skin and IgE radioimmunoassay (RIA) tests for NMBDs in 29 patients is presented and difficulties involved in interpreting the results of both tests are discussed. Methods for increasing the detection of NMBD-reactive IgE antibodies are outlined. In screening sera of patients for IgE antibodies to thiopentone and morphine as well as NMBDs, multiple drug reactivities have been detected in a few subjects. Attention is drawn to defects in the existing thiopentone RIA although it is clear that the test is specific in patients who react to the drug. Addition of the serum tryptase assay to skin tests and IgE RIAs for NMBDs, thiopentone and morphine provides a powerful combination of diagnostic tests for the investigation of anaphylactoid reactions to anaesthetic drugs.

Topics: Anaphylaxis; Anesthesia, General; Antibodies, Anti-Idiotypic; Chymases; Cross Reactions; Humans; Immunoglobulin E; Narcotics; Neuromuscular Blocking Agents; Radioimmunoassay; Serine Endopeptidases; Skin Tests; Thiopental; Tryptases

Topics: Alcuronium; Anaphylaxis; Anesthetics; Drug Hypersensitivity; Follow-Up Studies; Humans; Postoperative Period; Radioimmunoassay; Skin Tests; Succinylcholine; Thiopental

Topics: Anaphylaxis; Humans; Neuromuscular Blocking Agents; Radioimmunoassay; Thiopental

Topics: Adult; Anaphylaxis; Cross Reactions; Ethanolamine; Ethanolamines; Female; Humans; Immunoglobulin E; Male; Neuromuscular Blocking Agents; Radioimmunoassay; Succinylcholine; Thiopental

Tryptase is predominantly found in mast cells, where it resides in secretory granules, and is released with other mediators during mast cell degranulation. By using a newly developed commercial assay for measurements of tryptase levels we have investigated two cases of suspected drug-induced anaphylaxis. Each patient had a similar clinical presentation, consisting of hypotension and cyanosis after administration of thiopentone and suxamethonium. One of the patients showed a highly elevated serum level of tryptase reaching 26 micrograms/l 30 min after the initial reaction. In addition, slightly elevated levels of specific IgE antibodies to thiopentone were detected. The other patient with similar symptoms showed no increase in the level of tryptase, nor any specific IgE to thiopentone or suxamethonium. These data indicate the patient I suffered from true anaphylaxis, whereas the reaction of patient II occurred by a different mechanism.

Topics: Anaphylaxis; Anesthesia; Cytoplasmic Granules; Humans; Hypotension; Immunoglobulin E; Mast Cells; Peptide Hydrolases; Succinylcholine; Thiopental

Two women experienced anaphylactoid reactions after induction of general anaesthesia. Prick tests, intradermal tests (IDT), human basophil degranulation tests (HBDT) and a quaternary ammonium sepharose radioimmunoassay were undertaken several weeks later and repeated together with a leucocyte histamine release (LHR) test after 4 months. Anaphylaxis to suxamethonium was documented by four tests in patient 1 and to pancuronium by four tests in patient 2. Anaphylaxis to thiopentone was shown with IDT, HBDT and LHR in both women. It was concluded that simultaneous anaphylaxis to thiopentone and a neuromuscular blocker had occurred in these patients.

Topics: Adult; Anaphylaxis; Anesthesia, General; Basophil Degranulation Test; Drug Hypersensitivity; Female; Histamine Release; Humans; Intradermal Tests; Leukocytes; Pancuronium; Succinylcholine; Thiopental

The three currently available paper radioallergosorbent tests ('suxamethonium', alcuronium and thiopentone) were evaluated. 'Suxamethonium' radioallergosorbent test (which employs choline conjugated to paper discs) proved to be reliable in the detection of allergy to neuromuscular blockers, which were confirmed as the most common cause of anaphylactic reaction during general anaesthesia. Thiopentone radioallergosorbent test may also be useful, and is recommended in conjunction with 'suxamethonium' radioallergosorbent test in the preliminary investigation of reactions. Patients with positive 'suxamethonium' radioallergosorbent test usually require further testing, including alcuronium radioallergosorbent test, skin testing with a wide range of drug concentrations or leucocyte histamine release test.

Topics: Adolescent; Adult; Alcuronium; Anaphylaxis; Anesthesia, General; Antibodies; Child; Drug Hypersensitivity; Female; Histamine Release; Humans; Immunoglobulin E; Male; Middle Aged; Radioallergosorbent Test; Skin Tests; Succinylcholine; Thiopental

Thiopentone-specific IgE antibodies from the sera of subjects who experienced a life-threatening anaphylactic reaction to the drug and IgE antibodies that cross-react with thiopentone via substituted ammonium groups in either cyclic or acyclic form, were studied by direct binding immunoassays and quantitative hapten inhibition methods. Findings provided an explanation for the apparent 'non-specific' nature of some IgE antibody reactions with thiopentone and reinforce the conclusion that the thiopentone IgE immunoassay is a valuable aid in the diagnosis of immediate allergic reactions to the drug.

Topics: Anaphylaxis; Binding, Competitive; Drug Hypersensitivity; Haptens; Humans; Immunoglobulin E; Models, Molecular; Molecular Structure; Neuromuscular Blocking Agents; Radioimmunoassay; Thiopental

Topics: Anaphylaxis; Humans; Thiopental

Topics: Adult; Anaphylaxis; Anesthesia, Intravenous; Arthroscopy; Drug Hypersensitivity; Female; Humans; Propofol; Skin Tests; Thiopental

Topics: Anaphylaxis; Anesthesia, General; Drug Hypersensitivity; False Positive Reactions; Humans; Risk Factors; Thiopental

Topics: Adult; Anaphylaxis; Antibodies; Disease Outbreaks; Female; Hospitals; Humans; Immunoglobulin E; Male; Radioimmunoassay; Skin Tests; Thiopental

A previously healthy 63-yr-old female died following an anaphylactoid response to anaesthesia with thiopentone and suxamethonium. Postmortem findings strongly suggested that disseminated intravascular coagulation played a significant role in her death. The local mechanism behind the reaction is unknown, but the formation of thiopentone-suxamethonium colloid aggregates during induction, may have led to "aggregate anaphylaxis".

Topics: Anaphylaxis; Anesthesia, General; Disseminated Intravascular Coagulation; Female; Humans; Middle Aged; Succinylcholine; Thiopental

Profound myocardial depression developed in 2 patients after severe anaphylactic reactions following the induction of anaesthesia in 1 case and a bee-sting in the other. Neither patient had pre-existent cardiac disease. In both patients haemodynamic assessment, radionuclide ventriculography, and two-dimensional echocardiography confirmed the clinical impression of profound systolic myocardial dysfunction. Haemodynamic stability was attained by intra-aortic balloon counterpulsation, which was probably life-saving in both cases. Cardiac function improved rapidly although some contractile depression persisted for several days. At follow-up both patients had normal cardiac function with no evidence of underlying heart disease.

Topics: Adult; Alcuronium; Anaphylaxis; Animals; Bees; Female; Heart Diseases; Hemodynamics; Humans; Hypotension; Insect Bites and Stings; Intra-Aortic Balloon Pumping; Thiopental

Patients with Munchausen's syndrome often undergo multiple surgical operations under general anaesthesia. They tend to have multiple exposures to routinely used anaesthetic agents. A patient with Munchausen's syndrome who developed an anaphylactoid reaction to thiopentone is described and the importance of obtaining previous case notes is stressed.

Topics: Anaphylaxis; Anesthesia, General; Humans; Male; Middle Aged; Munchausen Syndrome; Risk Factors; Thiopental

A three-week-old girl presented for surgery for congenital pyloric stenosis. The anaesthetic technique included intravenous induction with thiopentone and neuromuscular blockade with atracurium. The administration of these drugs was followed within 2-3 minutes by oedema of the eyelids and epiglottis, reduced peripheral circulation and central cyanosis. There was no previous exposure to either drug and no definite family history of allergy. Analysis of subsequent sequential blood samples indicated that the reaction mechanism was non-immune and was presumed to be due to pharmacological release of histamine.

Topics: Anaphylaxis; Anesthesia, Intravenous; Atracurium; Drug Hypersensitivity; Female; Humans; Infant, Newborn; Isoquinolines; Neuromuscular Blocking Agents; Thiopental

Initial cardiac failure in anaphylactoid shock is rare, classically related to cardiac anaphylaxis occurring in a highly sensitized patient. However, this anaphylaxis is not always found; the case described here of a histamine shock with ventricular fibrillation after the injection of thiopentone is a good example of this. The severity of the shock may be explained by the presence of a prolapse of the small flap of the mitral valve.

Topics: Adult; Anaphylaxis; Female; Heart Arrest; Humans; Intraoperative Complications; Mitral Valve Prolapse; Thiopental

There is an increasing awareness of adverse drug reactions and particularly those relating to anaesthesia and surgery where a wide variety of substances may be administered intravenously. The intravenous route offers considerable therapeutic and diagnostic advantage to the clinician. With pharmacologically active drugs the route avoids drug deactivation by digestive enzymes and first-pass hepatic metabolism. With large volumes of fluids, electrolytes, blood, blood fractions and their substitutes it is the only possible way of administration.

Topics: Anaphylaxis; Anesthesia, Intravenous; Child; Drug Hypersensitivity; Etomidate; Histamine; Humans; Infant, Newborn; Injections, Intravenous; Polyethylene Glycols; Skin Tests; Thiopental

A radioimmunoassay was developed to detect IgE antibodies to the anaesthetic induction agent thiopentone. Significant levels of thiopentone-reactive IgE antibodies were found in the sera of two patients who had experienced life-threatening anaphylactoid reactions following administration of the drug. Inhibition experiments revealed that cross-reactivity occurs between the drug-reactive IgE antibodies and four barbiturate analogues pentobarbitone, phenobarbitone, barbitone and methohexital. The assay should supplement skin testing for the detection of patients with potentially lethal sensitivity to thiopentone.

Topics: Anaphylaxis; Anesthesia; Drug Hypersensitivity; Female; Humans; Immunoglobulin E; Middle Aged; Radioimmunoassay; Thiopental

Topics: Anaphylaxis; Anesthesia, General; Animals; Dog Diseases; Dogs; Drug Hypersensitivity; Injections, Intravenous; Male; Thiopental

A study of anaphylactoid reactions (AR) observed between September 1982 and September 1983 was carried out in the surgical departments of a French regional hospital. The patients who had presented clinical symptoms suggesting an AR (bronchospasm, collapse, tachycardia, with or without skin rash) during a general anaesthesia were included in this study. A precise history of previous anaesthesias and allergy was taken; allergological testing was carried out six to eight weeks after the AR. It included intradermal skin tests (ST) and a human basophil degranulation test (HBDT) with the suspected drugs. Out of 12,855 patients operated on under general anaesthesia in the hospital, 21 AR were seen during the year under study, in 18 women and 3 men, of median age 27 years (extreme values: 11 and 62). The median number of previous anaesthesias was 2 (extreme values: 0--in 4 cases- and 22). Cardiocirculatory abnormalities were the most frequent clinical symptoms of the AR: they consisted of decreased arterial pressure in 13 cases, with 8 cases of vascular collapse. Respiratory symptoms were less frequent but severe bronchospasm was observed in 5 cases. Skin rashes were seen simultaneously in 13 out of the 21 observations. A history of allergy was found in 11 patients. Total IgE serum concentration averaged 134 kU X 1(-1) (extreme values: 32-378). Results of histamine-sensitivity skin tests were not significantly different from those observed in a control group. Calcemia and magnesemia were in the normal range. One to four drugs were tested in each patient: 41 tests combining ST and HBDT were carried out.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Aged; Alfaxalone Alfadolone Mixture; Anaphylaxis; Anesthesia; Basophils; Child; Female; Humans; Male; Middle Aged; Neuromuscular Nondepolarizing Agents; Risk; Sex Factors; Skin Tests; Succinylcholine; Thiopental

Topics: Adult; Anaphylaxis; False Positive Reactions; Humans; Immunoglobulin E; Male; Radioallergosorbent Test; Thiopental

After injection of etomidate during surgery for herniation of an intervertebral disk an anaphylactoid reaction occurred. Generalized erythema, severe urticaria, and rise in heart rate and blood pressure drop were observed. After treatment with an antihistaminic and a corticosteroid the phenomenons completely disappeared within 45 minutes.

Topics: Alcuronium; Anaphylaxis; Anesthesia, Inhalation; Drug Interactions; Etomidate; Fentanyl; Halothane; Humans; Imidazoles; Injections, Intravenous; Intervertebral Disc Displacement; Male; Middle Aged; Nitrous Oxide; Thiopental

A 32-year-old female was admitted for a minor elective surgical procedure. Her past history included at least six uneventful general anaesthetics. Anaphylaxis developed shortly following induction of anaesthesia with thiopentone, Innovar and gallamine. Resuscitation was successful but was complicated by ventricular fibrillation. Full recovery followed. Subsequent allergy skin tests revealed hypersensitivity to thiopentone. Recommendations for investigation of suspected hypersensitivity to anaesthetic agents are included, as are guidelines for the recognition and treatment of anaphylaxis.

Topics: Adult; Anaphylaxis; Anesthetics; Droperidol; Drug Combinations; Drug Hypersensitivity; Female; Fentanyl; Gallamine Triethiodide; Humans; Skin Tests; Thiopental

Topics: Alfaxalone Alfadolone Mixture; Anaphylaxis; Anesthetics; Animals; Cats; Dogs; Drug Hypersensitivity; Humans; Injections, Intravenous; Plasma Substitutes; Polyethylene Glycols; Species Specificity; Thiopental

Topics: Anaphylaxis; Drug Hypersensitivity; Histamine Release; Humans; In Vitro Techniques; Leukocytes; Male; Middle Aged; Thiopental

Topics: Alfaxalone Alfadolone Mixture; Anaphylaxis; Humans; Thiopental

Anaphylaxis due to an anesthetic is one type of cardiovascular emergency that can occur during general anesthesia. Anaphylactic reactions to muscle relaxants have been documented. Barbiturates, used as sedatives, are well known to produce cutaneous reactions, but anaphylaxis after their ingestion seems to be rare. Generalized allergic reactions to thiopental sodium during anesthesia are mentioned in the product monograph for Penthothal sodium, and rare case reports of anaphylactic reactions to infused thiopental have appeared, generally in the anesthesiology literature. Documentation of the immunologic responses to thiopental sodium has been limited to the demonstration of an allergic reaction to thiopental by skin testing in some cases. This report describes a woman who, after having tolerated thiopental sodium and other general anesthetics, became sensitive to this agent and had a severe acute reaction at the time of induction of general anesthesia.

Topics: Adult; Anaphylaxis; Antibodies; Female; Histamine Release; Humans; Skin Tests; Thiopental

Topics: Acute Disease; Adult; Anaphylaxis; Antigen-Antibody Complex; Drug Hypersensitivity; Female; Humans; Immunoglobulin E; Radioallergosorbent Test; Thiopental; Time Factors

Topics: Anaphylaxis; Female; Humans; Immunoglobulin E; Middle Aged; Reagins; Thiopental

Topics: Adult; Anaphylaxis; Bronchial Spasm; Drug Eruptions; Drug Hypersensitivity; Erythema; Female; Halothane; Humans; Intubation, Intratracheal; Thiopental; Tubocurarine

A fit young mother had a severe anaphylactic response to intravenous injection of sodium thiopentone, having been sensitised nearly 20 years previously.

Topics: Adult; Anaphylaxis; Anesthesia, Intravenous; Female; Humans; Thiopental

A patient who had shown some evidence of immunological sensitivity underwent several operations under general anaesthesia for otitis media without ill effect. On his second exposure to Althesin, however, he suffered a severe reaction. Facial angioneurotic oedema was accompanied by peripheral vasodilatation and sweating, and C3 conversion was observed in his plasma. Subsequent anaesthetics produced no reactions until four years later, when thiopentone and suxamethonium were given. This reaction was much milder, but C3 conversion again occurred. Although the clinical signs indicated an anaphylactoid reaction, the laboratory findings suggested that this patient had an underlying immunopathological condition involving complement activation, which could be triggered by any intravenous agent that activated complement. The judgment that a reaction to a particular drug is anaphylactic cannot be made on the basis of clinical signs alone. Simple laboratory analysis will show whether the reaction is due to an underlying immunopathological condition that may be triggered by any of several drugs.

Topics: Adult; Alfaxalone Alfadolone Mixture; Anaphylaxis; Complement C3; Drug Hypersensitivity; Humans; Injections, Intravenous; Male; Pregnanediones; Succinylcholine; Thiopental

Topics: Adolescent; Adult; Aged; Amniotic Fluid; Anaphylaxis; Anesthetics; Drug Hypersensitivity; Embolism, Amniotic Fluid; Female; Humans; Pregnancy; Succinylcholine; Thiopental

In a patient who had been anaesthetised twice with penthiobarbitone, who had contracted a localised then a generalised eczema, collapse appeared during a third anaesthetic induction, 30 minutes after the injection of penthiobarbitone which was revealed by Shelley's test to be the most positive product.

Topics: Anaphylaxis; Anesthesia, General; Drug Hypersensitivity; Humans; Male; Middle Aged; Skin Tests; Thiopental

Two cases of anaphylactic shock during anaesthesia are presented, in which the etiology is confirmed by the lymphoblastic transformation test. In one case, the responsability was due to Pentothal, in the other to the combination of Pentothal-succinylcholine.

Topics: Adult; Anaphylaxis; Anesthesia, Intravenous; Drug Hypersensitivity; Female; Heart; Humans; Lymphocyte Activation; Succinylcholine; Thiopental

Topics: Alfaxalone Alfadolone Mixture; Anaphylaxis; Anesthetics; Drug Hypersensitivity; Histamine Release; Humans; Methohexital; Pancuronium; Propanidid; Succinylcholine; Thiopental

Eight clinical cases of anaphylactic accidents are presented: six arising during anaesthetic induction (four being probably true allergy) and two secondary to massive histamine-liberation during perfusion of Rheomacrodex.

Topics: Adolescent; Adult; Aged; Alcuronium; Alfaxalone Alfadolone Mixture; Anaphylaxis; Anesthesia; Atropine; Dextrans; Histamine Release; Humans; Male; Middle Aged; Phenoperidine; Propanidid; Succinylcholine; Thiopental

A case of anaphylaxis to thiopentone is reported and its immediate treatment with epinephrine is emphasized. Other reported cases of allergic reaction to thiopentone and to muscle relaxants are reviewed. There are no reliable diagnostic tests for allergy to these agents.

Topics: Anaphylaxis; Anesthesia; Drug Hypersensitivity; Epinephrine; Humans; Male; Middle Aged; Thiopental

Topics: Anaphylaxis; Anesthesia, Intravenous; Animals; Bronchial Spasm; Dog Diseases; Dogs; Drug Hypersensitivity; Keratitis; Male; Thiopental

Anaphylaxis to suxamethonium in patients who gave no history of allergy is presented in this report. The diagnosis of anaphylaxis was based on a rapid onset of tachycardia, arterial hypotension, erythematous patches and oedema, and a positive reaction to a sensitivity test.

Topics: Adolescent; Adult; Anaphylaxis; Blood Pressure; Chlorpheniramine; Dexamethasone; Female; Gluconates; Humans; Male; Methoxamine; Oxygen Inhalation Therapy; Promethazine; Skin Tests; Succinylcholine; Tachycardia; Thiopental

A case history is presented of a man who developed angioedema of his head and neck during anaesthesia for his 11th cystoscopy within four years. Thiopentone was always used to induce his general anaesthesia. An intradermal skin test with 1 : 100 dilution of 2-5 per cent thiopentone was positive and subsequent anaesthesia without thiopentone was straightforward.

Topics: Adult; Anaphylaxis; Angioedema; Humans; Male; Skin Tests; Thiopental

Topics: Anaphylaxis; Anesthesia, General; Constriction; Coronary Vessels; Female; Humans; Middle Aged; Muscles; Pain; Propanidid; Thiopental; Thorax

Topics: Adult; Anaphylaxis; Anesthesia, Intravenous; Bicarbonates; Dexamethasone; Drug Hypersensitivity; Female; Gallamine Triethiodide; Humans; Infusions, Parenteral; Intubation, Intratracheal; Metaraminol; Promethazine; Sodium; Thiopental

Topics: Adult; Anaphylaxis; Arteries; Basophils; Blood Pressure; Drug Hypersensitivity; Electrocardiography; Female; Gastric Juice; Glucocorticoids; Heart Rate; Histamine; Histamine H1 Antagonists; Histamine Release; Humans; Leukocyte Count; Male; Middle Aged; Plasma Substitutes; Preanesthetic Medication; Propanidid; Pulse; Skin Tests; Solvents; Thiopental

Topics: Adult; Anaphylaxis; Anesthesia, Intravenous; Cyanosis; Drug Hypersensitivity; Female; Humans; Tachycardia; Thiopental

Topics: Anaphylaxis; Anesthesia, General; Drug Hypersensitivity; Female; Humans; Middle Aged; Thiopental

Topics: Anaphylaxis; Anesthesia; Humans; Hypersensitivity; Thiopental