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Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2025, vol. 31, issue2
Subject Area: Medicine
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DOI: 10.5272/jimab.2025312.6230
Published online: 28 May 2025
Original article
J of IMAB. 2025 Apr-Jun;31(2):6230-6237
PATIENTS WITH ALLERGIES – PREOPERATIVE PREPARATION AND PREMEDICATION
Gergana Ivanova1, 2
, Margarita Atanasova1, 2,
1) Endocrine Surgery Clinic, University Specialized Hospital for Active Treatment of Endocrinology "Acad. Ivan Penchev", Sofia, Bulgaria.
2) Department of Anesthesia and Intensive Care, Medical Faculty, Medical University Sofia, Bulgaria.
ABSTRACT:
Purpose: The study investigates the need and effectiveness of preoperative prick test corticosteroids as antiallergic premedication for patients with a history of allergic reactions undergoing surgery under general anesthesia, focusing on hypersensitivity reactions (HSRs).
Material and Methods: A prospective clinical-epidemiological study was conducted with 60 patients, divided into groups receiving corticosteroid premedication (30 patients) and no premedication (30 patients). Patients had histories of allergies, and hypersensitivity was monitored intraoperatively and postoperatively. Data were analyzed using various statistical methods to assess the impact of corticosteroid use and prick tests.
Results: The study revealed no significant reduction in the incidence of mild or moderate-to-severe HSRs with corticosteroid premedication. Allergic reactions, including rash and bronchospasm, were observed in three patients despite receiving corticosteroids. Additionally, the absence of corticosteroid or H1/H2 blocker premedication did not increase the incidence of HSRs in other patients. Statistical analysis demonstrated a lack of correlation between premedication and the prevention of allergic reactions. The study proved that prick tests are not a reliable method to identify possible triggers of HSRs
Conclusion: Corticosteroid premedication does not effectively prevent perioperative HSRs in patients with allergic conditions. The study suggests that routine use of corticosteroids for this purpose should be reconsidered. A detailed allergy history is crucial for identifying at-risk patients, rather than prick tests and national protocols for managing perioperative HSRs reactions should be developed.
Keywords: Hypersensitivity Reactions, Perioperative Care, Anesthesia, Anaphylaxis, Premedication, Allergy,
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Please cite this article as: Ivanova G, Atanasova M. Patients with Allergies – Preoperative Preparation and Premedication. J of IMAB. 2025 Apr-Jun;31(2):6230-6237. [Crossref - 10.5272/jimab.2025312.6230]
Correspondence to: Gergana Ivanova, 2, Zdrave Str., Maichin dom Building, floor 11, Endocrine Surgery Clinic, 1606 Sofia, Bulgaria; E-mail: grivanova@medfac.mu-sofia.bg
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Received: 24 October 2024
Published online: 28 May 2025