Anesthesia Reactions May Be More Common Than Thought - at Least in France

J Allergy Clin Immunol 2011
Dr. Paul Michel Mertes of the University Hospital Center of Nancy in France reported that allergic reactions to anesthesia are rare, but they may be more common than some past studies have suggested.

Using two national databases;
1. Estimated that between 1997 and 2004, there were about 100 allergic reactions for every million anesthesia procedures performed in France. That's somewhat higher,if compared with the earlier estimates from a pair of studies in the 1990s -- including a French study that put the rate at 100 reactions for every 1.3 million anesthesia procedures.

2. Women appeared to be at particular risk
The rate of allergic reaction among women was 155 per million anesthesia procedures, versus 55 per million for men. Unclear is why women in this study had a significantly higher rate of allergic reaction than men.

3. 72% of allergic reactions were IgE-mediated. Among adults with IgE-mediated reactions, 60% suffered serious cardiovascular or breathing problems.

4. The common cause of allergic reactions are neuromuscular numbing agents (58%), Latex then followed by antibiotics, which were linked to 13% of allergic reactions.


Different opinion from Dr. Richard P. Dutton, executive director of the Anesthesia Quality Institute -- a U.S. group that was formed in 2008 to create a national registry on anesthesia outcomes.

1. The findings do not mean that the rate of allergic reactions to anesthesia is going up. Traditionally, there has been no systematic reporting of allergic reactions to anesthesia in the U.S., so there is no hard number to compare the French estimate to. The (French study)current findings are based on more-comprehensive reporting of allergic reactions than were the earlier studies.

2. Doubts about how applicable these findings would be in the U.S - "That doesn't match with the American experience," where antibiotics and propofol have been most commonly implicated in allergic reactions during anesthesia.

3. Why female are more prone to develop allergic reactions. But there are two theories, according to Dutton.
a. Strogen plays some role in the reactions to certain anesthesia agents.
b. French women may have been exposed to certain chemicals in cosmetics that primed their immune systems to react to structurally similar chemicals used in anesthesia.