Alergia y anestesia / Allergy and anesthesia

Octubre 25, 2017. No. 2892

Alergia a las benzodiazepinas con administración de anestesia: revisión de la literatura actual. Benzodiazepine Allergy With Anesthesia Administration: A Review of Current Literature. Haybarger E1, Young AS2, Giovannitti JA Jr3. Author information Anesth Prog. Fall 2016;63(3):160-7. doi: 10.2344/16-00019.1. Abstract The incidence of anaphylactic/anaphylactoid reactions has been reported to vary between 1:3500 and 1:20,000 cases with a mortality rate ranging from 3 to 9%. Clinical signs present as skin rash, urticaria, angioedema, bronchospasm, tachycardia, bradycardia, and hypotension. Rapid identification and treatment are crucial to overall patient prognosis, as delayed intervention is associated with increased mortality. Diagnosis may be confirmed with clinical presentation, serum tryptase levels, and skin test results. While the main causative agents in anesthetic practice are typically neuromuscular blocking agents (NMBs), latex, and antibiotics, this review aims to discuss recognition, management, and preventive measures in perioperative anaphylactic/anaphylactoid reactions from benzodiazepine administration. KEYWORDS: Anaphylactoid reactions; Anaphylaxis; Benzodiazepine allergy; Diagnosis of anaphylaxis; Management of anaphylaxis PDF Hipersensibilidad a los anestésicos locales Hypersensitivity to local anesthetics. Grzanka A, Wasilewska I, Śliwczyńska M, Misiołek H1. Author information Anaesthesiol Intensive Ther. 2016;48(2):128-34. doi: 10.5603/AIT.a2016.0017. Epub 2016 Mar 15. Abstract Using local anaesthetics in daily practice, particularly by anaesthetists and dentists, is connected with the risk of side effects. Therefore, the observation of side effects, carrying out detailed research (according to the chart proposed in this study) and conducting specialist examinations is of the highest importance. There is a variety of side effects that could occur during local anaesthesia procedures, with the intensity ranging from clinically unimportant to life threatening. Clinicians' major concerns are the appearance of various hypersensitivity reactions, including anaphylaxis. Healthcare providers responsible for the administration of local anaesthetics should be able to detect hypersensitivity reactions to implement appropriate treatment and then choose highly selected diagnostic procedures. The final diagnosis should be based on specific medical history; documentation, including a description of the case and measurement of tryptase activity; skin tests; and provocation trials. Screening tests are not recommended in populations without hypersensitivity to local anaesthestics in their medical history. KEYWORDS: hypersensitivity; local anestehtics; local anesthesia; skin tests PDF XXVII Congreso Peruano de Anestesiología Lima, Noviembre 2-4, 2017 Informes / Informataion

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

Alergia al metal como causa de fracaso del implante en la artroplastia de hombro

http://www.mihombroycodo.com.mx/academia/alergia-al-metal-como-causa-de-fracaso-del-implante-en-la-artroplastia-de-hombro/

Metal Allergy as a Cause of Implant Failure in Shoulder Arthroplasty

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28776630

https://www.healio.com/orthopedics/journals/ortho/%7B17eb7718-dfb7-44fe-82f6-c5243d807fe6%7D/metal-allergy-as-a-cause-of-implant-failure-in-shoulder-arthroplasty

De:

Ko JK,Nicholson TA,Hoffler CE,Williams G Jr,Getz C.

Orthopedics.

2017 Aug 3:1-5. doi: 10.3928/01477447-20170719-01. [Epub ahead of print]

Todos los derechos reservados para:

Copyright 2017, SLACK Incorporated.

Abstract

Metal allergy is an uncommon and poorly understood cause of failure of orthopedic implants. To the authors’ knowledge, there have been no reports of the management of shoulder arthroplasty patients with metal allergy. The authors present their experience with the diagnosis and management of patients with metal allergy. Patients with metal allergy undergoing shoulder arthroplasty were identified through retrospective chart review from January 1, 2012, to January 31, 2015. Case characteristics collected included patient risk factors (age, sex, prior cutaneous reactions to metal), metal allergy factors (type of metal allergy, method of diagnosis), and surgery factors (implant type, primary/revision, type of shoulderarthroplasty). Outcomes measured included American Shoulder and Elbow Surgeons score, Penn Shoulder Score, andSingle Assessment Numeric Evaluation score. Eleven patients were identified with metal allergy. Five were diagnosed prior to the index arthroplasty, and 6 were diagnosed after shoulder replacement. The diagnosis was made through skin patch testing, memory lymphocyte immunostimulation assay, or clinical history. Patients identified after implantation presented with progressive pain and stiffness, but none had cutaneous manifestations. Patients with metal allergy had better results undergoing primary shoulder arthroplasty than undergoing revision. Metal allergy is rare but may be a clinically significant cause of unsatisfactory shoulder arthroplasty. Given the superior results of primary shoulder arthroplasty compared with revision, screening for metal allergy by clinical history is recommended. [Orthopedics. 201x; xx(x):xx-xx.].

Resumen

La alergia al metal es una causa poco común y poco conocida de fracaso de los implantes ortopédicos. Según los autores, no ha habido informes de manejo de pacientes con artroplastia de hombro con alergia al metal. Los autores presentan su experiencia en el diagnóstico y manejo de pacientes con alergia al metal. Los pacientes con alergia a los metales sometidos a artroplastia de hombro fueron identificados a través de la revisión retrospectiva de las cartas desde el 1 de enero de 2012 hasta el 31 de enero de 2015. Las características del caso recogidas incluyeron factores de riesgo del paciente (edad, sexo, reacciones cutáneas previas al metal) alergia al metal, método de diagnóstico) y factores quirúrgicos (tipo de implante, primaria / revisión, tipo de artroplastia de hombro). Los resultados medidos incluyeron la puntuación de los cirujanos americanos de hombro y codo, la puntuación de hombro de Penn y la puntuación de la evaluación numérica de la evaluación individual. Once pacientes fueron identificados con alergia al metal. Cinco fueron diagnosticados antes de la artroplastia índice y 6 fueron diagnosticados después del reemplazo del hombro. El diagnóstico se realizó mediante pruebas de parches cutáneos, ensayos de inmunoestimulación con linfocitos de memoria o historia clínica. Los pacientes identificados después de la implantación presentaron dolor progresivo y rigidez, pero ninguno presentó manifestaciones cutáneas. Los pacientes con alergia al metal tuvieron mejores resultados sometidos a artroplastia primaria de hombro que sometidos a revisión. La alergia al metal es rara pero puede ser una causa clínicamente significativa de artroplastia de hombro insatisfactoria. Dado los resultados superiores de la artroplastia primaria del hombro comparada con la revisión, se recomienda el cribado para la alergia del metal por la historia clínica. [Ortopedía. 201x; Xx (x): xx – xx.].

Copyright 2017, SLACK Incorporated.

PMID:  28776630   DOI:  

10.3928/01477447-20170719-01

#artroplastia#hombro#alergia