Anaphylaxis in the operating room

A patient under anaesthesia cannot report throat tightness, dizziness, or nausea, and surgical drapes may hide hives or flushing. The clinical team may first see an unexpected fall in blood pressure, difficulty ventilating the lungs, airway swelling, bronchospasm, or changes in heart rate. Severe perioperative reactions may have no obvious skin signs.

Many substances can be given close together around an operation, including antibiotics, anaesthetic medicines, muscle relaxants, antiseptics, dyes, blood products, and latex-containing equipment. The medicine given nearest to the reaction is not automatically the cause; reconstructing the full timeline is central to later investigation.

The team calls for help, stops possible triggers where practical, supports the airway and breathing, gives adrenaline, and treats poor circulation with intravenous fluids and other critical-care measures as needed. Anaesthetic monitoring helps clinicians follow oxygen levels, heart rhythm, blood pressure, ventilation, and response to treatment. The operation may be paused or changed according to the patient’s stability and urgency.

After stabilisation, staff document every exposure and its timing. Blood samples taken at clinically appropriate times can support the assessment, but they do not identify the culprit by themselves. A specialist allergy review later combines the anaesthetic record, event details, and targeted testing.

Seek urgent help after discharge if breathing difficulty, throat or tongue swelling, wheezing, faintness, or collapse develops or returns. Use prescribed adrenaline if the discharge plan directs it and summon an ambulance. For future procedures, tell the surgical and anaesthetic teams about the event before any medicines or preparations are given.

Request a clear account of what happened, a list of all substances used, and written advice on what to avoid pending allergy assessment. Ask when specialist testing should occur, which alternatives may be suitable, and how confirmed allergies will be recorded. Carry the resulting letter or alert information to every future healthcare visit.