Egg and Soy Allergies and Propofol Use

Abstract

Anesthesiologists and sedationists often use propofol as the main anesthetic agent for brief procedures, such as esophagogastroduodenoscopy with biopsy for eosinophilic esophagitis (EoE). Pediatric patients presenting for endoscopy often have a history of reflux as well as drug and food allergies. Specifically, patients with EoE often have sensitivity to egg and soy, as well as milk and dairy products, tree nuts/peanuts, and seafood (fish/shellfish). Propofol use is often cited as a contraindication in patients with hypersensitivity to egg and soy. Current literature does not support avoiding propofol in egg- and soy-allergic patients. Most practitioners, however, continue to avoid propofol in patients with a history of egg anaphylaxis due to lack of evidence supporting its safe use in this population.