Perioperative Anaphylaxis
Conditions
Interventions
Gold Standard:At present, one of the gold-standard methods for allergen detection is skin testing. The criteria for a positive result are as follows:
1.Skin Prick test:
Performed on the volar aspect o
the presence of erythema or pruritus further supports a positive reaction.
2. Skin Intradermal test:
Inject 0.02–0.03 mL of the diluted test solution intradermally into the volar aspect of the forearm
the presence of erythema and pruritus further supports a positive reaction.
3.Positive control:
Inject 0.02–0.03 mL of the diluted test solution intradermally into the volar aspect of the forearm to f
the presence of erythema and pruritus further supports a positive reaction.
Basophil activation test: this is currently one of the mainstream methods for allergen diagnosis, with high specificity
when combined with skin testing, it can achieve high accuracy in identifying causative allergens. The specific procedure is as follows:
(1) Draw 5 mL of peripheral blood from the patient and immediate
(2) Add 50 µL of the corresponding stimulant to each pre-labeled tube for that patient
(3) Add 100 µL of stimulation buffer and 50 µL of the patient’s whole-blood sample to each tube
(4) After stimulation, ad
Sponsors
China-Japan Friendship Hospital
Eligibility
Sex/Gender
All
Age
7 Years to 80 Years
Inclusion criteria
Inclusion criteria: Diagnostic criteria for perioperative allergic reactions are defined as clinical manifestations occurring within 15 minutes of anaesthetic administration, involving but not limited to the following organ systems: 1. Circulatory system: hypotension, tachycardia, or rapid progression to severe arrhythmias, circulatory collapse, or cardiac arrest; 2. Respiratory system: Increased salivation and sputum secretion, laryngospasm, bronchospasm, wheezing and moist rales in the lungs; 3. Digestive system: nausea, vomiting, or diarrhoea; 4. Skin and mucous membranes: skin flushing, various rashes (particularly large urticaria-like papules), subcutaneous angioedema, generalised skin oedema, oedema of nasal, ocular, and pharyngeal mucosa; 5. Two investigators independently assess each allergic case; discrepancies are resolved by a third investigator; 6. At least one positive skin test and/or basophil activation test for the suspected drug; mast cell activation testing to be supplemented where necessary.
Exclusion criteria
Exclusion criteria: Exclusion Criteria 1. Presence of the aforementioned systemic manifestations, but inability to exclude non-allergic conditions requiring differential diagnosis, such as asthma attacks, haemorrhagic shock, excessive anaesthesia depth, or pulmonary embolism; 2. Inability to discontinue medications such as antihistamines or corticosteroids that may interfere with diagnostic tests (e.g., skin prick tests, basophil activation tests, mast cell activation tests); 3. Concurrent severe immune system disorders, haematological conditions, or dermatological diseases that may affect allergen test results; 4. Patients experiencing an allergic reaction within 4–6 weeks prior to testing; 5. Patients refusing to participate in the trial.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Skin temperature; | — |
Secondary
| Measure | Time frame |
|---|---|
| wheal size in skin testing;Basophil activation test result; | — |
Countries
China
Contacts
Public Contactjing zhao
China-Japan Friendship Hospital
Outcome results
None listed