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Anaesthesia in a patient with multiple drug allergies
Anaphylactic reaction occurring during anaesthesia remains a major cause of concern for anaesthetists. It can have various causes because patients can be exposed to a large number of drugs and other substances over a relatively short period of time. Latex allergy should always be considered as a potential cause of perioperative anaphylaxis. Hypotension, cyanosis and bronchospasm are the most common manifestations of intraoperative anaphylaxis. Management includes initial supportive therapy and follow-up management, including detailed documentation and thorough investigation to identify the predisposing factor(s). It is the anaesthetist’s responsibility to ensure that any suspected anaphylactic reaction is thoroughly investigated using immediate and post-operative testing; failure to do so may lead to wrong diagnosis and other life-threatening events on repeated exposure. There are two pillars for safe perioperative management: an active policy of high-risk identification during preoperative assessment and specialized allergists to provide expert advice throughout the perioperative period.