Evaluation of the Attitude of Anesthetists About Anaphylaxis in Turkey

¹ Department of Anesthesiology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey

² Department of Pediatric Allergy and Immunology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey

³ Department of Anesthesiology, University of Health Sciences, Ankara Etlik Zubeyde Hanim Maternity and Gynecology Training and Research Hospital, Ankara, Turkey

⁴ Department of Anesthesiology, University of Health Sciences, Dr. Sami Ulus Obstetrics and Pediatrics Training and Research Hospital, Ankara, Turkey

⁵ Division of Pediatric Allergy and Immunology, Department of Children’s Health and Diseases, Mugla Sitki Kocman University Faculty of Medicine, Mugla, Turkey

EJMO 2018, 2(3), 146–151; https://doi.org/10.14744/ejmo.2018.02997

Submitted: 6 March 2018 | Accepted: 30 April 2018 | Published: 8 May 2018

© 2018 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )

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Abstract

Objectives: Anaphylactic reactions are important health problems encountered by anesthesiologists during anesthesia administration. The aim of the study was to determine the attitude of anesthesiologists regarding the management of anaphylactic reactions.

Methods: Anesthesiologists across the country were administered a questionnaire consisting of 24 questions that evaluated their attitude regarding anesthesia management in anaphylactic reactions.

Results: A total of 223 (70.4% female) anesthesiologists were included in our study. Participants’ level of knowledge for recognizing the signs of anaphylaxis was sufficient. Furthermore, 89.7% of the participants knew that anaphylaxis could occur without skin symptoms. The rate of using adrenalin for anaphylaxis treatment was 74.8%, and the proportion of participants who knew the dose correctly was 65%. The adrenalin administration route was stated as intravenous by 52.5% and intramuscular by 13.1% of the participants. The rate of preoperative questioning of the patient’s history of a drug and food allergy was 91.5% and 81.2%, respectively. The answers revealed that 61% of the participants were worried when administering anesthesia to a patient with history of drug allergy.

Conclusion: Although the knowledge of anesthetists regarding anaphylaxis is generally sufficient, its importance emphasized during specialized training should be continuously updated.

Keywords

Anaphylaxis

anesthetists

attitude

drug allergy

Conflict of interest

None declared.

References

1. Butterworth JF, Mackey DC, Wasnick JD. Morgan and Mikhail's Clinical. Anesthesiology. 5th New York, NY: McGraw-Hill, 2013. p. 1217–2. Axon AD, Hunter JM. Anaphylaxia and anaesthesia-all clear now? Br J Anaesth 2004;93:501–505.
2. Axon AD, Hunter JM. Editorial III: Anaphylaxis and anaesthesia-all clear now? Br J Anaesth 2004;93:501–5. [CrossRef]
3. Birnbaum J, Porri F, Pradal D, Charpin D, Vervloet D. Allergy during anaesthesia. Clin Exp Allergy 1994;24:916–21. [CrossRef]
4. Michalska–Krzanowska G. Anaphylactic reactions during anaesthesia and the perioperative period. Review Article. Anaes-thesiol Intensive Ther 2012;44:104–11.
5. Kroigaard M, Garvey LH, Gillberg L, Johansson SG, Mosbech H, Florvaag E, et al. Scandinavian Clinical Practice Guidelines on the diagnosis, management and follow-up of anaphylaxis during anaesthesia. Acta Anaesthesiol Scand 2007;51:655–70.
6. Soetens FM. Anaphylaxis during anaesthesia: diagnosis and treatment. Acta Anaesthesiol Belg 2004;55:229–37.
7. Whittington T, Fisher MM. Anaphylactic and anaphylactoid reactions. Clin Anaesthesiol 1998;12:301–23. [CrossRef]
8. Mertes PM, Laxenaire MC, Alla F; Groupe d'Etudes des Réactions Anaphylactoïdes Peranesthésiques. Anaphylactic and anaphylactoid reactions occurring during anesthesia in France in 1999-2000. Anesthesiology 2003;99:536–45. [CrossRef]
9. Girotra V, Lalkhen A. Anaphylaxis. Anaesth Intensive Care 2014;15:15–9. [CrossRef]
10. Ebo DG, Fisher MM, Hagendorens MM, Bridts CH, Stevens WJ. Anaphylaxis during anaesthesia: diagnostic approach. Allergy 2007;62:471–87. [CrossRef]
11. Mertes PM, Lambert M, Guéant-Rodriguez RM, Aimone-Gastin I, Mouton-Faivre C, Moneret-Vautrin DA, et al. Perioperative anaphylaxis. Immunol Allergy Clin North Am 2009;29:429–51.
12. Mertes PM, Alla F, Tréchot P, Auroy Y, Jougla E; Groupe d'Etudes des Réactions Anaphylactoïdes Peranesthésiques. .Anaphylaxis during anesthesia in France: an 8-year national survey. J Allergy Clin Immunol 2011;128:366–73. [CrossRef]
13. Mertes PM, Laxenaire MC; GERAP. Anaphylactic and anaphylactoid reactions occurring during anaesthesia in France. Seventh epidemiologic survey (January 2001-December 2002) [Article in French]. Ann Fr Anesth Reanim 2004;23:1133–43.
14. Rodriguez J, Crespo JF, Lopez-Rubio A, De La Cruz-Bertolo J, Ferrando-Vivas P, Vives R, et al. Clinical cross-reactivity among foods of the Rosaceae family. J Allergy Clin Immunol 2000;106:183–9. [CrossRef]
15. Sturm JM, Temprano J. A survey of physician practice and knowledge of drug allergy at a university medical center. J Allergy Clin Immunol Pract 2014;2:461–4. [CrossRef]
16. Erkoçoğlu M, Civelek E, Azkur D, Özcan C, Öztürk K, Kaya A, et al. Knowledge and attitudes of primary care physicians regarding food allergy and anaphylaxis in Turkey. Allergol Immunopathol (Madr) 2013;41:292–7. [CrossRef]
17. Simons FE, Ebisawa M, Sanchez-Borges M, Thong BY, Worm M, Tanno LK, et al. 2015 update of the evidence base: World Allergy Organization anaphylaxis guidelines. World Allergy Organ J 2015;8:32. [CrossRef]
18. Monsieurs KG, Nolan JP, Bossaert LL, Greif R, Maconochie IK, Nikolaou NI; ERC Guidelines 2015 Writing Group. European Resuscitation Council Guidelines for Resuscitation 2015: Section 1. Executive summary. Resuscitation 2015;95:1–80. [CrossRef]
19. Harper NJ, Dixon T, Dugué P, Edgar DM, Fay A, Gooi HC, et al; Working Party of the Association of Anaesthetists of Great Britain and Ireland. Suspected Anaphylactic Reactions Associated with Anaesthesia. Anaesthesia 2009;64:199–211. [CrossRef]
20. Ewan PW, Dugué P, Mirakian R, Dixon TA, Harper JN, Nasser SM. BSACI guidelines fort he investigation of suspected anaphylaxis during general anaesthesia. Clinical Experimental Allergy 2009; 40:15–31. [CrossRef]
21. Michavila Gomez AV, Belver Gonzalez MT, Alvarez NC, Giner Muñoz MT, Hernando Sastre V, Porto Arceo JA; Drug allergy Work Group of the Spanish Society of Paediatric Allergy, Immunology (SEICAP). Perioperative anaphylactic reactions: Review and procedure protocol in paediatrics. Allergol Immunopathol (Madr) 2015;43:203–14. [CrossRef]
22. Mertes PM, Tajima K, Regnier-Kimmoun MA, Lambert M, Iohom G, Guéant-Rodriguez RM, et al. Perioperative Anaphylaxis. Med Clin N Am 2010;94:761–89. [CrossRef]
23. Perioperative anaphylaxis: diagnosis, evaluation, and management. Immunol Allergy Clin North Am 2015;35:321–34
24. Gomes ER, Demoly P. Epidemiology of hypersensitivity drug reactions. Curr Opin Allergy Clin Immunol 2005;5:309–16.
25. Klieman P, Fredman B, Goldberg A, Confino-Cohen R. Drug allergy in hospitalized perioperative patients: the contribution of a structured questionnaire for accurate diagnosis. Research Article. Immunotherapy 2013;5:837–41. [CrossRef]

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