Anaphylactic Shock in the Operating Room

Abstract

Although anaphylactic shock that occurs in the operating room is infrequent, it has to be dealt with promptly and appropriately because it is life-threatening if mishandled. Major causative agents are neuromuscular blocking agents and their antagonists and antibiotics. In addition to clinical symptoms, measurement of histamine and tryptase concentration in blood is useful for diagnosis. The first choice of drug treatment is adrenaline. Although the skin test is the gold standard for identifying causative agents, basophil activation tests that can be performed in vitro are promising tests. It is the anesthesiologist’s responsibility to identify the cause of the anaphylaxis since the patient may be at risk for anaphylaxis recurrence in the next surgery if the causative agent is left unidentified.