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Epidemiology of perioperative anaphylaxis in France in 2017–2018: the 11th GERAP survey

2024; Elsevier BV; Volume: 132; Issue: 6 Linguagem: Inglês

10.1016/j.bja.2024.01.044

1471-6771

Charles Tacquard, Julien Serrier, Simon Viville, A.M. Chiriac, Sébastien Franchina, Aurélie Gouel‐Chéron, A. Giraudon, Morgan Le Guen, Diane Le Quang, J. M. Malinovsky, Nadine Petitpain, P. Démoly, Paul‐Michel Mertès, Morisset Martine, Husser Solène, Huyn Vinh An, Perquin Mélanie, L. Florence, Feesenmeyer Christine, Pellerin Christelle, Bordes-Demolis Marilyne, Giraudon Antoine, Vaia Elleni, Mariotte Delphine, Ollivier Yann, Serrier Julien, Dalampira Georgia, Muti Daniela, Baud Charlotte, Clermont Ferrand, Capo-Chichi Rosita, Seltzer Sandrine, Vandenbergue-Durr Sophie, Zambelli Valentina, Pottier Eloïse, Mear Amélie, Pouessel Guillaume, Facon Alain, Pelletier De Chambure Diane, Delebarre-Sauvage Christine, Caron Juliette, Bellet Elisabeth, Orsel Isabelle, Diane Le Quang, Mullet Christelle, Diot-Junique Nathalie, Ferrenq-Dubost Rolande, Billard Carine, Lefervre Sébastien, Chiriac Anca, P. Démoly, Gouitaa Marion, Serrano Eva, T. Ruel Marie, Hassan El Hanache, Colas Luc, Aguinet Emmanuelle, Petit Isabelle, Rezzadori Gilles, Patel Minaxi, Miran Sophie, Merzouk Aïcha, Smilov Magdalena, Gouel-Cheron Aurélie, Neukirch Catherine, Karila-Beaulier Chantal, Lepage David, S Alice, Verdaguer Marion, Renauld Valérie, Malinovsky Jean-Marc, Rochefort-Morel Cécile, Dessard Sabrina, L Guillou, Franchina Sébastien, Meunier Yannick, G. Emmanuel, Nafeh Samer, Delzanno Cédric, Dolley Charles, Stenger Rodolphe, Tacquard Charles, Mertes Paul-Michel, Morgan Le Guen, Gil Céline, Mailhol Claire, Migueres Isabelle, Huchon Cyrille,

Allergic Rhinitis and Sensitization

BackgroundPerioperative anaphylaxis is rare but is associated with significant morbidity. This complication has been well described in France by the GERAP (Groupe d'Etude des Réactions Anaphylactiques Périopératoires), a network focused on its study. The epidemiology of perioperative anaphylaxis is evolving, influenced by environmental factors and clinical practice. The aim of this study was to update the epidemiology of perioperative anaphylaxis in France.MethodsThis multicentre retrospective study was performed in 26 allergy clinics of the GERAP network in 2017–8.ResultsThere were 765 patients with perioperative anaphylaxis included. Most cases were severe, with 428 (56%) reactions graded as 3 or 4 according to the Ring and Messmer classification. Skin test results were available for 676 patients, with a culprit agent identified in 471 cases (70%). Neuromuscular blocking agents were the main cause of perioperative anaphylaxis (n=281; 60%), followed by antibiotics (n=118; 25%) and patent blue dye (n=11; 2%). Cefazolin was the main antibiotic responsible for perioperative anaphylaxis (52% of antibiotic-related reactions). Suxamethonium and rocuronium were the main neuromuscular blocking agents responsible for perioperative anaphylaxis with 7.1 (6.1–8.4) and 5.6 (4.2–7.4) reactions per 100,000 vials sold, respectively, whereas cefazolin-related cases were estimated at 0.7 (0.5–0.9) reactions per 100,000 vials sold.ConclusionsOur results confirm that most commonly identified triggering agents remain neuromuscular blocking agents. Reactions to antibiotics, particularly cefazolin, are becoming increasingly frequent. The origin of sensitisation to cefazolin is unknown, as no cross-sensitisation has been described, and it should be the subject of further study. Perioperative anaphylaxis should be followed over the years and understood given the changing triggers.Clinical trial registrationClinicalTrials.gov (NCT 04654923).