鸡蛋或大豆过敏的成年患者对丙泊酚的过敏反应:来自单个机构大型数据库的回顾性队列研究

贵州医科大学   麻醉与心脏电生理课题组

翻译:安丽   编辑：张中伟   审校：曹莹

背景：近年来，许多报告表明，在西方国家，丙泊酚对鸡蛋/大豆过敏的患者是安全的。鸡蛋过敏在亚洲更为常见，但关于成人使用丙泊酚引起的过敏反应的报道有限。本研究旨在确定丙泊酚是否会引起鸡蛋/大豆过敏患者的过敏反应。

方法: 纳入了2018年至2021年在麻醉医师参与下进行手术的成年患者。在所有患者中，我们查阅了所有患者电子病历中的食物过敏信息，并记录了使用的麻醉药物。在对鸡蛋/大豆过敏患者中，根据术中丙泊酚是否使用情况，分为两组。我们在麻醉诱导后24小时内评估各组的过敏反应。主要结果是鸡蛋/大豆过敏患者使用丙泊酚后发生过敏反应的相对风险。

结果：总共查看了22111名患者，28710份麻醉记录。在鸡蛋/大豆过敏患者中，173（0.8%）名患者和237（0.8%）份麻醉记录被纳入研究。在记录的鸡蛋/大豆过敏患者中，151人使用了丙泊酚，86人没有使用。鸡蛋/大豆过敏患者使用丙泊酚后发生过敏反应的相对风险为1.14（95%置信区间，0.10–12.4；P= 0.74）。

结论：对鸡蛋/大豆过敏的患者使用异丙酚不会显着增加过敏反应的相对风险。因此，即使是对鸡蛋/大豆过敏的患者，麻醉医师也可以灵活决定丙泊酚的使用适应证。

原始文献来源：Masaki Iwakiri, Reo Inoue and Kanji Uchida.Allergic reactions to propofol inadult patients with egg or soybean al lergy: a retrospective cohort study from a large database of a single institute.Iwakiri et al. JA Clinical Reports (2023) 9:1.Doi.org/10.118 /s40981-022-00591-8.

英文原文：

Allergic reactions to propofol inadult patients with egg or soybean al lergy: a retrospective cohort study from 

a large database of a single institute

Abstract

Background: In recent years, many reports have indicated that propofol is safe to administer to patients with egg/soybean allergy in Western countries. Egg allergy is more frequent in Asia, but there are limited reports regarding allergic reactions to propofol use among adults. This study aimed to determine whether propofol causes allergic reactions in patients with egg/soybean allergy.

Methods: Adult patients who underwent surgery involving anesthesiologists from 2018 to 2021 were included. In all patients, we reviewed food allergy information in their electronic medical record and extracted anesthetics. Patients with egg/soybean allergy were subdivided into two groups on the basis of intraoperative use of propofol. We evaluated each group for allergic reactions within 24 h after the induction of anesthesia. The primary outcome was a relative risk of allergic reactions after propofol use for patients with egg/soybean allergy.

Results: In total, 22,111 patients with 28,710 anesthesia records were identifed. Among patients with egg/soybean allergy, 173 (0.8%) patients and 237 (0.8%) anesthesia records were included in the study. Among the records of egg-/soybean-allergic patients, 151 were administered propofol, and 86 were not. The relative risk of allergic reactions after propofol use for patients with egg/soybean allergy was 1.14 (95% confdence interval, 0.10–12.4; p = 0.74).

Conclusions: The use of propofol in patients with egg/soybean allergy does not signifcantly increase the relative risk of allergic reactions. Therefore, anesthesiologists can appropriately determine the indication for propofol, even in patients with egg/soybean allergy.