Anaesthetic/Drug Adverse Reactions (NARCOS)

Immunology

---

Description

The intravenous route of drug administration is a source of immediate hypersensitive-type ( anaphylactic ) or direct histamine release ( anaphylactoid ) reactions. The severity of these reactions can vary widely. General anaesthesia accounts for many adverse drug reactions. Reactions can occur on first exposure and it is clear that a wide range of mechanisms operate. The essential feature of all these mechanisms is the release of vasoactive mediators. The basic assessment is carried out by plasma tryptase analysis. The tryptase concentration can reflect both the clinical severity of the reaction and indicate the potential reaction mechanism. The causative agent can be investigated using specific IgE assays. Following completion of the tests along with examining the clinical history, the results will be reported to the anaesthetist and referring laboratory. Documentation including the following details should be sent with the sample( s ) to aid interpretation: i. Patient details ii. Sender and contact details iii. Surgical procedure iv. Date of reaction v. Drugs administered ( including pre-medication and sequences if possible ) vi. Clinical manifestations vii. Management of the reaction and outcome viii. Previous medical and anaesthetic history if known ix. Any risk factors ( asthmatic, penicillin allergy, anaesthetic reaction or extremely anxious patient, etc ) The haematological data, if available.

---

Indications

Investigation and advice on adverse drug reactions.

---

Sample Type

2mL Serial Serum ( Gel 5mL Yellow tube ) or 2mL serial Plasma samples. Sample 1: within 1 hour of onset of reaction Sample 2: 3 hours post reaction Sample 3: 24 hours post reaction. Requests from outside Sheffield: Transport at ambient temperature via Royal Mail or Courier.

---

Reference Range

Results, interpretation & advice.

---

Turnaround Time

Within 5 days

---

Testing Frequency

Weekly

---

External Notes

Please discuss with a Clinical Scientist / Consultant. Full details are required for interpretation.

---

References

See Tryptase and Specific IgE.

---

See Also

Tryptase; Allergen specific IgE.

Please note: the above information is subject to change and we endeavour to keep this website up to date wherever necessary.