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23-08-2011 | Surgery | Article

Anaphylaxis during anesthesia ‘more common in women than men’

Abstract

Free abstract

MedWire News: The incidence of allergic reactions during anesthesia is significantly higher in women than men, say French researchers.

"The safety of anesthesia has been significantly improved during the last decades. However, it may still be considered risky because it results from the exposure of a patient to a mixture of drugs that deliberately alter physiological functions in a short space of time," explain Paul Michel Mertes (Hôpital Central, CHU de Nancy) and colleagues.

They add: "Increasing attention has been paid over these last decades to allergic reactions that may occur during the very vulnerable perioperative period. However, despite systematic efforts aimed at characterizing the epidemiology of these reactions, it remains poorly defined."

To investigate further, the team studied combined data from the Groupe d'Etudes des Réactions Anaphylactiques Peranesthésiques (GERAP) database, the French Pharmacovigilance System, and a French national survey of anesthesia for the period 1997-2004.

Data on a total of 2516 patients who experienced a suspected allergic reaction during anesthesia were included in the analysis. Of these, a diagnosis of immunoglobulin (Ig)E-mediated immediate hypersensitivity reaction was established in 72.2%, with the remaining 27.8% considered non-IgE-mediated hypersensitivity reactions.

Hypersensitivity reaction rates and the distribution according to the mechanism of hypersensitivity remained stable throughout the study period, the researchers note.

The most common causes of anaphylactic reactions during anesthesia were neuromuscular blocking agents (58.1%), followed by latex (19.7%), and antibiotics (12.9%).

Considering that more than 7,700,000 anesthetic procedures are performed each year in France, the researchers calculated that the overall median annual incidence of anaphylactic reactions was 100.6 per 1 million procedures.

However, the median annual incidence of anaphylactic reactions was significantly higher in women than men, at 154.9 versus 55.4 per 1 million procedures.

The researchers note that in children, there was no significant gender difference in the incidence of allergic reactions during anesthesia.

Mertes and team conclude: "These results should be taken into account in the evaluation of the benefit-to-risk ratio of the various anesthetic techniques."

They add: "The similar incidence of reactions according to sex before adolescence suggests a role for sex hormones in the increase of anaphylaxis observed in women."

By Mark Cowen

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