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Current Anesthesiology Reports

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09-09-2023 | Anaphylaxis | Neuromuscular Blockade (CA Lien, Section Editor)

Anaphylactic Responses to Neuromuscular Blockade Drugs and Reversal Drugs

Authors: Alice C. Quayle, Tim M. Cook

Published in: Current Anesthesiology Reports | Issue 4/2023

Abstract

Purpose of Review

This review discusses the incidence of anaphylaxis to neuromuscular blockade drugs (NMBDs), the mechanism and clinical features, as well as theories around sensitisation (including the pholcodine hypothesis), the developing area of anaphylaxis to reversal agents, and testing practices.

Recent Findings

The incidence and characteristics of anaphylaxis to NMBDs have recently been better established by large observational studies. In addition to the well-established IgE-mediated mechanism, new research has highlighted other mechanisms, including the mast cell receptor “MRGPRX2.” Sensitisation through other pharmacological, environmental, or occupational exposure appears to exist, with a body of evidence implicating pholcodine resulting in its recent withdrawal from the European market. The impact of this is awaited. Sugammadex has become an increasing area of focus. Whilst initially proposed as a potential treatment for anaphylaxis, the weight of evidence does not support this and importantly sugammadex has emerged as a cause of anaphylaxis.

Summary

Anaphylaxis to NMBDs is an important cause of patient collapse and mortality during the perioperative period. Thorough understanding of this topic is essential for all clinicians using these drugs.

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Title: Anaphylactic Responses to Neuromuscular Blockade Drugs and Reversal Drugs
Authors: Alice C. Quayle
Tim M. Cook
Publication date: 09-09-2023
Publisher: Springer US
Keywords: Anaphylaxis
Anaphylaxis
Rocuronium
Succinylcholine
Published in: Current Anesthesiology Reports / Issue 4/2023
Electronic ISSN: 2167-6275
DOI: https://doi.org/10.1007/s40140-023-00575-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Anaphylactic Responses to Neuromuscular Blockade Drugs and Reversal Drugs

Abstract

Purpose of Review

Recent Findings

Summary

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose of Review

Recent Findings

Summary

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