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Histamine release in anaesthesia and surgery. Premedication with H1- and H2-receptor antagonists: Indications, benefits and possible problems

Histamin-Freisetzung in der Anästhesie und Chirurgie. Prämedikation mit H1- und H2-Rezeptor-Antagonisten: Indikationen, Vorteile und mögliche Probleme

  • 6. Prophylaxis And Treatment Of Adverse Reactions And Histamine Release In Anaesthesia And Surgery — H1- And H2-Receptor Antagonists
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Summary

Our clinical and experimental studies have so far demonstrated, that the drugs used in anaesthesia; such as hypnotics, sedatives, narcotics or muscle relaxants, release histamine.

The intravenous short acting anaesthetic etomidat has not shown either in experimental studies or in clinical use for 10 years any anaphylactoid reaction. The benzodiazepines are another group of drugs which appear not to release high amounts of histamine.

Accurate studies on volunteers as well as on patients on the application of H1- and H2-receptor antagonists have demonstrated an effective inhibition of the anaphylactoid reaction. We suggest that in case of a history of allergy H1- and H2-receptor antagonists should be administered as a prophylactic premedication.

Zusammenfassung

Die in der Anaesthesie verwendeten i.v. Hypnotika, Anaesthetika und Muskelrelaxantien sind in der Lage Histamin freizusetzen. Dies ist das Ergebnis einer 12jährigen klinisch-experimentellen Forschung.

Das i.v. zu applizierende Hypnotikum Etomidat hat sowohl im Experiment als auch nach 10jähriger klinischer Erfahrung noch keine anaphylaktoide Reaktion verursacht. Aber auch die Benzodiazepine sind keine potenten Histaminfreisetzer.

Die Applikation von H1- und H2-Rezeptor-Antagonisten erscheint nach sorgfältiger Prüfung sowohl im klinischen Experiment als auch in der Klinik in der Lage zu sein, anaphylaktoide Reaktionen zu verhindern. Es wird daher bei entsprechender Anamnese eine prophylaktische Praemedikation mit H1- und H2-Rezeptor-Antagonisten empfohlen.

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Authors and Affiliations

  1. Department of Anaesthesia, Surgical Out-Patient-Department of the University of Munich, Pettenkoferstr. 8a, D-8000, München 2, Federal Republic of Germany

    A. Doenicke

  2. Department of Theoretical Surgery, Centre of Operative Medicine I, University of Marburg, Robert-Koch-Str. 8, D-3350, Marburg/Lahn, Federal Republic of Germany

    W. Lorenz

Authors
  1. A. Doenicke
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  2. W. Lorenz
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Additional information

Karl-Thomas-Award of the German Society of Anaesthesiology and Intensive Care 1981

Supported by Grant of Deutsche Forschungsgemeinschaft (Lo 199) 13-6

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Doenicke, A., Lorenz, W. Histamine release in anaesthesia and surgery. Premedication with H1- and H2-receptor antagonists: Indications, benefits and possible problems. Klin Wochenschr 60, 1039–1045 (1982). https://doi.org/10.1007/BF01716968

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