JSA Practical Guidelines for Response to Perioperative Anaphylaxis

Abstract

  Anaphylaxis is one of the most serious adverse events that can occur during the perioperative period and presents with immunological or non-immunological reactions to the causative agent. Sufficient recognition of the diagnosis and treatment of anaphylaxis is necessary, as the disease can rapidly become severe if not treated promptly and accurately. The initial treatment for anaphylaxis, as with emergency resuscitation, is to secure the airway, assist ventilation, maintain hemodynamics, administer an appropriate dose of adrenaline, provide a high concentration of oxygen for inhalation, and maintain adequate infusion. The treatment of anaphylaxis during anesthesia is not particularly different from the general response ; the main difference is that the venous route will already have been secured during the induction of anesthesia.

  In February 2021, the Japanese Society of Anesthesiologists published the “Practical guideline for the response to perioperative anaphylaxis”. This practical guideline is divided into seven sections : 1) an “Essential summary,” followed by 2) “Introduction,” 3) “Epidemiology,” 4) “Preoperative diagnosis,” 5) “Diagnosis at disease onset,” 6) “Treatment,” and 7) “Postoperative diagnosis.” These guidelines provide explanations and guidance based on current research findings. It is hoped that this practical guideline will be revised and improves as further evidence accumulates.