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Use of alpha‐agonists for management of anaphylaxis occurring under anaesthesia: case studies and review
Author(s) -
Heytman M.,
Rainbird A.
Publication year - 2004
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2004.03968.x
Subject(s) - medicine , anaphylaxis , epinephrine , anesthesia , metaraminol , allergy , blood pressure , immunology
Summary Anaphylaxis is an uncommon but serious complication of anaesthesia. Most current guidelines for the management of anaphylaxis list only epinephrine as a vasopressor to use in the event of cardiovascular collapse. We present two cases of anaphylaxis under anaesthesia where return of spontaneous circulation was refractory to epinephrine, but occurred following the administration of the alpha‐agonist metaraminol. Potential advantages and disadvantages of using epinephrine in this setting, the role of alpha‐agonists and some potential mechanisms accounting for their role in successful management are reviewed.