Acta chirurgica Iugoslavica 2011 Volume 58, Issue 2, Pages: 177-183
https://doi.org/10.2298/ACI1102177V
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Preoperative evaluation of patients with history of allergy
Veličković Jelena (Center for Anesthesia, Clinical Center of Serbia, Belgrade)
Lađević Nebojša (Center for Anesthesia, Clinical Center of Serbia, Belgrade + School of Medicine, Belgrade)
Milaković Branko (Center for Anesthesia, Clinical Center of Serbia, Belgrade + School of Medicine, Belgrade)
Likić-Lađević Ivana (Clinic for Ginecology, Clinical Center of Serbia, Belgrade)
Ugrinović Đorđe (School of Medicine, Clinical Center Kragujevac, Kragujevac)
Kalezić Nevena (Center for Anesthesia, Clinical Center of Serbia, Belgrade + School of Medicine, Belgrade)
The prevalence of allergic reactions in general population shows a constant
rise. It has been estimated that up to 40% of surgical patients have a
positive history of some kind of allergy. These patients represent a
challenge during perioperative evaluation, since they can be exposed to a
large variety of drugs and substances during surgery and anesthesia. A lot of
adverse drug reactions show similar clinical presentation with allergic
reactions. The latter are usually poorly explored since preoperative
allergology testing is performed in a limited number of patients. Management
of patients with history of allergy is impeded by the fact that most of
allergens cross-react in a manner that is not always easy to predict.
Allergies can manifest themselves with a broad spectrum of clinical symptoms,
ranging from mild skin symptoms such as itch and urticaria, to a
life-threatening anaphylactic reactions followed by hypotension, bronchospasm
and cardiovascular collapse. Prevention of allergic reactions during
perioperative period requires detailed history taking in order to identify
patients at risk, optimization of anesthesia strategy, pharmacological
premedication and further allergology diagnostic work-up in selected cases.
Keywords: allergy, perioperative management, anesthesia, surgery
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