Tabela 1
Classificação da gravidade e sinais clínicos da anafilaxia1414. Reducing the risk of the anaphylaxis during anaesthesia. Short text. Ann Fr Anesth Reanim. 2011;30:212-22.,1515 Mertes PM, Malinovsky JM, Jouffroy L. Working Group of the SFAR and SFA, Aberer W, Tereehorst I, et al. Reducing the risk of anaphylaxis during anesthesia: 2011 update guidelines for clinical practice. J Investig Allergol Clin Immunol. 2011;21:442-53.,1616 Hopkins PM, Cooke PJ, Clarke RC, et al. Consensus clinical scoring for suspected perioperative immediate hypersensitivity reactions. Br J Anaesth. 2019;123:e29-37.
Tabela 2
Diagnóstico de anafilaxia perioperatória2828 Spindola MAC, da Silva J. Anafilaxia e anestesia. In: In: Nunes RR, Bagatini A, Duarte LTD (org), Sociedade Brasileira de Anestesiologia. PROANESTESIA Programa de Atualização em Anestesiologia: Ciclo 1. Porto Alegre: Artmed Panamericana; 2018. p. 9-49 (Sistema de Educação Continuada à Distância, vol. 3).
Tabela 3
Diagnóstico diferencial de hipersensibilidade durante o período intraoperatório. Adaptado de 1515 Mertes PM, Malinovsky JM, Jouffroy L. Working Group of the SFAR and SFA, Aberer W, Tereehorst I, et al. Reducing the risk of anaphylaxis during anesthesia: 2011 update guidelines for clinical practice. J Investig Allergol Clin Immunol. 2011;21:442-53.,2626 Kolawole H, Marshall SD, Crilly H, et al. Australian and New Zealand Anaesthetic Allergy Group/Australian and New Zealand College of Anaesthetists Perioperative Anaphylaxis Management Guidelines. Anaesth Intensive Care. 2017;45:151-8.,2727 Dewachter P, Mouton-Faivre C, Hepner DL. Perioperative Anaphylaxis: what should be known?. Curr Allergy Asthma Rep. 2015;15:21.
Tabela 4
Possíveis desencadeantes da reação de hipersensibilidade no período intraoperatório, de acordo com a relação temporal. Adaptado de 2929 Ewan PW, Dugué P, Mirakian R, et al. BSACI guidelines for the investigation of suspected anaphylaxis during general anesthesia. Clin Exp Allergy. 2009;40:15-31.,3030 Laguna JJ, Archilla J, Doña I, et al. Practical guidelines for perioperative hypersensitivity reactions. J Investig Allergol Immunol. 2018;28:216-32.,3131 Volcheck GW, Mertes PM. Local and general anesthetics immediate hypersensitivity reactions. Immunol Allergy Clin N Am. 2014;34:525-46.
Tabela 5
Conduta relacionada à gravidade1212 Ebo DG, Clarke RC, Mertes PM, et al. Molecular mechanisms and pathophysiology of perioperative hypersensitivity and anaphylaxis: a narrative review. Br J Anaesth. 2019;123:e38-e49.,2828 Spindola MAC, da Silva J. Anafilaxia e anestesia. In: In: Nunes RR, Bagatini A, Duarte LTD (org), Sociedade Brasileira de Anestesiologia. PROANESTESIA Programa de Atualização em Anestesiologia: Ciclo 1. Porto Alegre: Artmed Panamericana; 2018. p. 9-49 (Sistema de Educação Continuada à Distância, vol. 3).
Tabela 6
Tratamento imediato da anafilaxia. Adaptado de77 Garvey LH, Dewachter P, Hepner DL, et al. Management of suspected immediate perioperative allergic reactions: an international overview and consensus recommendations. Br J Anaesth. 2019;123:e50-e64.,2626 Kolawole H, Marshall SD, Crilly H, et al. Australian and New Zealand Anaesthetic Allergy Group/Australian and New Zealand College of Anaesthetists Perioperative Anaphylaxis Management Guidelines. Anaesth Intensive Care. 2017;45:151-8.,3030 Laguna JJ, Archilla J, Doña I, et al. Practical guidelines for perioperative hypersensitivity reactions. J Investig Allergol Immunol. 2018;28:216-32.,4040 Kanwar M, Irvin CB, Frank JJ, et al. Confusion about epinephrine dosing leading to iatrogenic overdose: a life-threatening problem with a potential solution. Ann Emerg Med. 2010;55:341-4.
Tabela 7
Métodos de dluição de adrenalina2626 Kolawole H, Marshall SD, Crilly H, et al. Australian and New Zealand Anaesthetic Allergy Group/Australian and New Zealand College of Anaesthetists Perioperative Anaphylaxis Management Guidelines. Anaesth Intensive Care. 2017;45:151-8.
Tabela 8
Conduta na anafilaxia refratária77 Garvey LH, Dewachter P, Hepner DL, et al. Management of suspected immediate perioperative allergic reactions: an international overview and consensus recommendations. Br J Anaesth. 2019;123:e50-e64.,2525 Kroigaard M, Garvey LH, Gillberg L, et al. Scandinavian Clinical Practice Guidelines on the diagnosis, management and follow-up of anaphylaxis during anaesthesia. Acta Anesthesiol Scand. 2007;51:655-70.
Tabela 9
Manejo sugerido para suspeita de anafilaxia e alergia perioperatória em crianças77 Garvey LH, Dewachter P, Hepner DL, et al. Management of suspected immediate perioperative allergic reactions: an international overview and consensus recommendations. Br J Anaesth. 2019;123:e50-e64.,2626 Kolawole H, Marshall SD, Crilly H, et al. Australian and New Zealand Anaesthetic Allergy Group/Australian and New Zealand College of Anaesthetists Perioperative Anaphylaxis Management Guidelines. Anaesth Intensive Care. 2017;45:151-8.
Tabela 10
Acompanhamento após a reação anafilática77 Garvey LH, Dewachter P, Hepner DL, et al. Management of suspected immediate perioperative allergic reactions: an international overview and consensus recommendations. Br J Anaesth. 2019;123:e50-e64.,3030 Laguna JJ, Archilla J, Doña I, et al. Practical guidelines for perioperative hypersensitivity reactions. J Investig Allergol Immunol. 2018;28:216-32.,4040 Kanwar M, Irvin CB, Frank JJ, et al. Confusion about epinephrine dosing leading to iatrogenic overdose: a life-threatening problem with a potential solution. Ann Emerg Med. 2010;55:341-4.,8282 Muraro A, Roberts G, Worm M, et al. Anaphylaxis: Guidelines from the European Academy of Allergy and Clinical Immunology. Allergy. 2014;69:1026-45.,8383 Demoly P, Adkinson NF, Brockow K, et al. International consensus on drug allergy. Allergy. 2014;69:420-37.
Tabela 11
Conduta na alta do paciente77 Garvey LH, Dewachter P, Hepner DL, et al. Management of suspected immediate perioperative allergic reactions: an international overview and consensus recommendations. Br J Anaesth. 2019;123:e50-e64.,2626 Kolawole H, Marshall SD, Crilly H, et al. Australian and New Zealand Anaesthetic Allergy Group/Australian and New Zealand College of Anaesthetists Perioperative Anaphylaxis Management Guidelines. Anaesth Intensive Care. 2017;45:151-8.,3030 Laguna JJ, Archilla J, Doña I, et al. Practical guidelines for perioperative hypersensitivity reactions. J Investig Allergol Immunol. 2018;28:216-32.,4040 Kanwar M, Irvin CB, Frank JJ, et al. Confusion about epinephrine dosing leading to iatrogenic overdose: a life-threatening problem with a potential solution. Ann Emerg Med. 2010;55:341-4.
