Drug metabolism and personalized therapy · 2026
Allergic reactions to anaesthetics in surgery: current challenges and perspectives.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Zofia Lisiecka Maria, Luczak Joanna
Аннотация
INTRODUCTION: This study was conducted to assess the current state of issues related to AR to anaesthetics used in surgical procedures.
CONTENTS: A literature review of scientific publications in allergology and anaesthesiology was performed, evaluating the allergenic profile of modern anaesthetics and analysing approaches to preventing AR during surgery.
SUMMARY: Currently, the most commonly used local anaesthetics are amides, including lidocaine, bupivacaine, articaine, mepivacaine, ropivacaine, and levobupivacaine. These are considered safer in terms of allergenicity compared to their ester-based predecessors - novocaine, benzocaine, and tetracaine - as their metabolites rarely act as allergens. Among general anaesthetics, intravenous agents such as propofol, midazolam, etomidate, and ketamine, as well as inhalational agents including sevoflurane, isoflurane, desflurane, and xenon, are widely used. These are generally safer than their predecessor, thiopental, with xenon currently exhibiting the highest safety profile due to its inert chemical properties. Muscle relaxants have the highest allergenic potential, as their mechanism of action - blocking acetylcholine receptors - can lead to cell damage and the release of immune-stimulating substances. The only representative of depolarising muscle relaxants is succinylcholine, while non-depolarising agents include atracurium, cisatracurium, vecuronium, rocuronium, pancuronium, and mivacurium.
OUTLOOK: Preventive measures to reduce the risk of AR include: a detailed patient history and diagnostic testing using skin tests, provocation tests, and/or blood tests for Immunoglobulin E (IgE); replacement of the allergenic drug with a safer alternative if an allergy is confirmed; close monitoring for allergic manifestations during surgery, with professional preparedness for resuscitation in cases of anaphylaxis; postoperative patient monitoring to detect potential delayed AR; documentation of all AR for future reference. The findings of this study may be applied in clinical practice to mitigate the risks of AR associated with anaesthetic use during surgical interventions.
CONTENTS: A literature review of scientific publications in allergology and anaesthesiology was performed, evaluating the allergenic profile of modern anaesthetics and analysing approaches to preventing AR during surgery.
SUMMARY: Currently, the most commonly used local anaesthetics are amides, including lidocaine, bupivacaine, articaine, mepivacaine, ropivacaine, and levobupivacaine. These are considered safer in terms of allergenicity compared to their ester-based predecessors - novocaine, benzocaine, and tetracaine - as their metabolites rarely act as allergens. Among general anaesthetics, intravenous agents such as propofol, midazolam, etomidate, and ketamine, as well as inhalational agents including sevoflurane, isoflurane, desflurane, and xenon, are widely used. These are generally safer than their predecessor, thiopental, with xenon currently exhibiting the highest safety profile due to its inert chemical properties. Muscle relaxants have the highest allergenic potential, as their mechanism of action - blocking acetylcholine receptors - can lead to cell damage and the release of immune-stimulating substances. The only representative of depolarising muscle relaxants is succinylcholine, while non-depolarising agents include atracurium, cisatracurium, vecuronium, rocuronium, pancuronium, and mivacurium.
OUTLOOK: Preventive measures to reduce the risk of AR include: a detailed patient history and diagnostic testing using skin tests, provocation tests, and/or blood tests for Immunoglobulin E (IgE); replacement of the allergenic drug with a safer alternative if an allergy is confirmed; close monitoring for allergic manifestations during surgery, with professional preparedness for resuscitation in cases of anaphylaxis; postoperative patient monitoring to detect potential delayed AR; documentation of all AR for future reference. The findings of this study may be applied in clinical practice to mitigate the risks of AR associated with anaesthetic use during surgical interventions.