20
Management
Table 12. Agents Frequently Implicated in Perioperative
Anaphylaxis and Probable Mechanisms of Adverse
Reactions
Agent
IgE-mediated
mast cell
activation
Complement-
mediated
mast cell
activation
Direct
mast cell
activation
Muscle relaxants d-tubocurarine
Suxamethonium (succinylcholine)
Pancuronium
Atracurium
Vecuronium
+ – +
Hypnotics and barbiturates
iopental
Methohexitone
+ + +
Nonbarbiturate hypnotics
Propofol
Althesin
± + +
Opioids
Morphine
Buprenorphine
Fentanyl
± – +
Plasma expanders
Dextran
Hydroxyethyl starch
– + +
Protamine + + +
Radiocontrast media – + +
Latex + – –
Chlorhexidine +
Supravital dyes +
