没有证据表明对鸡蛋、大豆或花生过敏的成年人使用异丙酚有禁忌症。

L. L. Asserhøj, H. Mosbech, M. Krøigaard, L. H. Garvey
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引用次数: 98

摘要

背景丙泊酚被认为是对鸡蛋、大豆或花生过敏的患者产生过敏反应的潜在原因,因为目前的配方中含有鸡蛋卵磷脂和大豆油的乳剂。然而,除了6例缺乏过敏反应确凿证据的病例报告外,没有证据表明这两种类型的过敏之间存在联系。本研究的目的是检查异丙酚过敏的频率,并调查对鸡蛋、大豆或花生具有特异性免疫球蛋白E (IgE)的患者是否耐受异丙酚。方法研究A系统调查了273例疑似围手术期过敏反应患者的异丙酚过敏发生率。其中153人接触过异丙酚,并接受了皮肤试验和静脉注射刺激。研究B回顾性调查了520例对鸡蛋、大豆或花生特异性IgE阳性的成年患者异丙酚暴露和耐受性。结果A研究中153例丙泊酚暴露患者中有4例(2.6%)诊断为丙泊酚过敏。其中3例仅在静脉注射刺激时检测呈阳性。这四个人在吃鸡蛋、大豆或花生时都没有过敏症状,他们的血清中也没有检测到对鸡蛋或大豆的特定IgE水平。在研究B中,我们从99例对鸡蛋、大豆或花生有特定IgE的患者中检索到171例麻醉图表,没有发现对异丙酚过敏的迹象。结论异丙酚过敏与鸡蛋、大豆、花生过敏无相关性。目前在这类食物过敏患者中选择异丙酚替代品的做法是没有证据基础的,应该重新考虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
No evidence for contraindications to the use of propofol in adults allergic to egg, soy or peanut†.
BACKGROUND Propofol is thought to be a potential cause of allergic reactions in patients allergic to egg, soy or peanut, since current formulations contain an emulsion that includes egg lecithin and soybean oil. However, other than six case reports lacking in confirmatory evidence of an allergic reaction, there is no evidence linking the two types of allergies. The aim of this study was to examine the frequency of propofol allergy and to investigate if patients with specific immunoglobulin E (IgE) to egg, soy or peanut tolerated propofol. METHODS Study A examined the frequency of propofol allergy in 273 patients systematically investigated for suspected perioperative allergic reactions. Of these, 153 had been exposed to propofol and underwent skin tests and intravenous provocation. Study B retrospectively investigated propofol exposure and tolerance in 520 adult patients with a positive specific IgE to egg, soy or peanut. RESULTS Four of the 153 propofol-exposed patients (2.6%) investigated in study A were diagnosed with propofol allergy. Of these, three tested positive only on intravenous provocation. None of the four had allergic symptoms when eating egg, soy or peanut and none had detectable levels of specific IgE to egg or soy in their serum. In study B we found no signs of allergic reactions towards propofol in 171 retrieved anaesthetic charts from 99 patients with specific IgE to egg, soy or peanut. CONCLUSION No connection between allergy to propofol and allergy to egg, soy or peanut was found. The present practice of choosing alternatives to propofol in patients with this kind of food allergy is not evidence based and should be reconsidered.
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