Analysis of suspected perioperative allergic reaction in patients undergoing neurosurgery
Objective To explore the characteristics of suspected perioperative allergic reaction in patients undergoing neurosurgery under general anesthesia.Methods Patients underwent neurosurgery under general anesthesia in Beijing Tiantan Hospital,Capital Medical University from January 2017 to February 2023 were selected.All patients with suspected allergic reaction were retrieved through the electronic medical record system and were divided into grade Ⅰ-Ⅱ group andⅢ-Ⅳ group according to the allergy classification.The general information,common symptoms and treatment of suspected allergic reaction were compared between the two groups.Results A total of 73 283 patients were included,among which 57 patients had suspected allergic reaction,and the incidence rate was 0.1%.Among the 57 patients,there were 28 males and 29 females aged from 1 to 78 years,with an average age of(41.0±21.0)years.There were seven patients(12.3%)with gradeⅠ allergic reaction,42 patients(73.7%)with grade Ⅱ allergic reaction and eight patients(14.0%)with grade Ⅲ allergic reaction,and no patients with grade IV allergic reaction.Among the 57 patients,13 cases(22.8%)had symptoms of cardiovascular system and skin,eight cases(14.0%)had cardiovascular system and respiratory system,and four cases(7.0%)had symptoms of three major systems.Compared with grade Ⅲ-Ⅳ group,the Ⅰ-Ⅱ group had a higher BMI[23.4(20.0,26.0)kg/m2 vs.20.2(19.6,22.7)kg/m2],lesser decreased rate of BP[46.0(27.5,56.0)%vs.59.5(53.0,61.5)%],lesser incidence of arrhythmia(53.1%vs.100.0%),and lesser utilization rate of epinephrine(51.0%vs.100.0%),and the differences were statistically significant(all P<0.05).Conclusions The incidence of suspected perioperative allergic reaction in neurosurgery under general anesthesia is relatively high,and the cardiovascular system symptoms are the most common symptoms of suspected allergic reactions in neurosurgery perioperative period.In clinic,suspicious allergens can be combined with early detection and diagnosis,and suspicious allergic reactions during perioperative period can be treated in time to improve the prognosis of patients.
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