No evidence for contraindications to the use of propofol in adults allergic to egg, soy or peanut
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No evidence for contraindications to the use of propofol in adults allergic to egg, soy or peanut. / Asserhøj, L L; Mosbech, H; Krøigaard, M; Garvey, L H.
I: British Journal of Anaesthesia, Bind 116, Nr. 1, 2016, s. 77-82.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - No evidence for contraindications to the use of propofol in adults allergic to egg, soy or peanut
AU - Asserhøj, L L
AU - Mosbech, H
AU - Krøigaard, M
AU - Garvey, L H
N1 - © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.
PY - 2016
Y1 - 2016
N2 - 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.
AB - 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.
KW - Adult
KW - Anesthesia, Intravenous
KW - Drug Hypersensitivity
KW - Egg Hypersensitivity
KW - Female
KW - Food Hypersensitivity
KW - Humans
KW - Male
KW - Middle Aged
KW - Netherlands
KW - Peanut Hypersensitivity
KW - Propofol
KW - Retrospective Studies
KW - Skin Tests
KW - Soybeans
KW - Young Adult
KW - Journal Article
U2 - 10.1093/bja/aev360
DO - 10.1093/bja/aev360
M3 - Journal article
C2 - 26675952
VL - 116
SP - 77
EP - 82
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
SN - 0007-0912
IS - 1
ER -
ID: 180966956