Practical aspects of perioperative anaphylaxis

SummaryPerioperative anaphylaxis is rare, difficult to diagnose, occurs unexpectedly and can have a very rapid onset with severe life threatening symptoms. Many anaesthesiologists have no first-hand experience of perioperative anaphylaxis and symptoms and signs may be difficult to differentiate from normal variations during anaesthesia. In addition skin symptoms may be absent or hidden by drapes. A good prognosis relies on prompt diagnosis and correct treatment. Due to the large number of drugs and substances used perioperatively, specialised investigations are needed to determine the cause. Anaesthesiologists need to be aware of anaphylaxis as a possible perioperative adverse event and should be confident in the correct management. This review seeks to give an overview of some practical aspects of perioperative anaphylaxis applicable to anaesthesiologists in their daily practice.