Survey for a suspected perioperative hypersensitivity reaction

As you likely know, immediate perioperative hypersensitivity (POH) reactions constitute a significant health problem with serious consequences if diagnosis is wrong. However, correct identification of the culprit agent(s) is challenging, given the simultaneous exposure to multiple agents. Moreover, anaesthetized patients can demonstrate normal variations in vital signs which can be misinterpreted as POH and vice versa.

Key information (which can only be provided by the attending anaesthetist who witnessed the reaction) for correct orientation of diagnostic tests, consists of a detailed description of the suspected reaction and the administered drugs as well as measurement of mast cell tryptase ideally drawn 60-90 minutes after onset.

A working group of anaesthetists and allergists created and recently updated the survey for a suspected POH reaction.