Propofol use in children with allergies to egg, peanut, soybean or other legumes

D. L. Sommerfield, M. Lucas, A. Schilling, T. F.E. Drake-Brockman, A. Sommerfield, A. Arnold, B. S. von Ungern-Sternberg

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Propofol is the most commonly administered intravenous agent for anaesthesia in children. However, there are concerns that the emulsified preparation may not be safe in children with an allergy to egg, peanut, soybean or other legumes. We conducted a retrospective study of children with immunologically confirmed egg, peanut, soybean or legume allergy and who underwent general anaesthesia at Princess Margaret Hospital for Children between 2005 and 2015. We extracted details regarding allergy diagnosis, each anaesthetic administered and any adverse events or signs of an allergic reaction in the peri-operative period. A convenience sample of patients without any known food allergies was identified from our prospective anaesthesia research database and acted as a control group. We identified 304 food-allergic children and 649 procedures where propofol was administered. Of these, 201 (66%) had an egg allergy, 226 (74%) had a peanut allergy, 28 (9%) had a soybean allergy and 12 (4%) had a legume allergy. These were compared with 892 allergy-free patients who were exposed to propofol. In 10 (3%) allergy patients and 124 (14%) allergy-free patients, criteria for a possible allergic reaction were met. In nine of the food-allergic children and in all the controls valid non-allergic explanations for the clinical symptoms were found. One likely mild allergic reaction was experienced by a child with a previous history of intralipid allergy. We conclude that genuine serious allergic reaction to propofol is rare and is not reliably predicted by a history of food allergy.

Original languageEnglish
Number of pages8
JournalAnaesthesia
DOIs
Publication statusE-pub ahead of print - 11 May 2019

Fingerprint

Egg Hypersensitivity
Propofol
Soybeans
Fabaceae
Hypersensitivity
Food Hypersensitivity
Arachis
Peanut Hypersensitivity
Food
Intravenous Anesthesia

Cite this

@article{235ba2162bcb43b5b14cf56d8fb21d86,
title = "Propofol use in children with allergies to egg, peanut, soybean or other legumes",
abstract = "Propofol is the most commonly administered intravenous agent for anaesthesia in children. However, there are concerns that the emulsified preparation may not be safe in children with an allergy to egg, peanut, soybean or other legumes. We conducted a retrospective study of children with immunologically confirmed egg, peanut, soybean or legume allergy and who underwent general anaesthesia at Princess Margaret Hospital for Children between 2005 and 2015. We extracted details regarding allergy diagnosis, each anaesthetic administered and any adverse events or signs of an allergic reaction in the peri-operative period. A convenience sample of patients without any known food allergies was identified from our prospective anaesthesia research database and acted as a control group. We identified 304 food-allergic children and 649 procedures where propofol was administered. Of these, 201 (66{\%}) had an egg allergy, 226 (74{\%}) had a peanut allergy, 28 (9{\%}) had a soybean allergy and 12 (4{\%}) had a legume allergy. These were compared with 892 allergy-free patients who were exposed to propofol. In 10 (3{\%}) allergy patients and 124 (14{\%}) allergy-free patients, criteria for a possible allergic reaction were met. In nine of the food-allergic children and in all the controls valid non-allergic explanations for the clinical symptoms were found. One likely mild allergic reaction was experienced by a child with a previous history of intralipid allergy. We conclude that genuine serious allergic reaction to propofol is rare and is not reliably predicted by a history of food allergy.",
keywords = "allergy, paediatric anaesthesia, propofol, retrospective cohort review",
author = "Sommerfield, {D. L.} and M. Lucas and A. Schilling and Drake-Brockman, {T. F.E.} and A. Sommerfield and A. Arnold and {von Ungern-Sternberg}, {B. S.}",
year = "2019",
month = "5",
day = "11",
doi = "10.1111/anae.14693",
language = "English",
journal = "Anaesthesia",
issn = "0003-2409",
publisher = "John Wiley & Sons",

}

Propofol use in children with allergies to egg, peanut, soybean or other legumes. / Sommerfield, D. L.; Lucas, M.; Schilling, A.; Drake-Brockman, T. F.E.; Sommerfield, A.; Arnold, A.; von Ungern-Sternberg, B. S.

In: Anaesthesia, 11.05.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Propofol use in children with allergies to egg, peanut, soybean or other legumes

AU - Sommerfield, D. L.

AU - Lucas, M.

AU - Schilling, A.

AU - Drake-Brockman, T. F.E.

AU - Sommerfield, A.

AU - Arnold, A.

AU - von Ungern-Sternberg, B. S.

PY - 2019/5/11

Y1 - 2019/5/11

N2 - Propofol is the most commonly administered intravenous agent for anaesthesia in children. However, there are concerns that the emulsified preparation may not be safe in children with an allergy to egg, peanut, soybean or other legumes. We conducted a retrospective study of children with immunologically confirmed egg, peanut, soybean or legume allergy and who underwent general anaesthesia at Princess Margaret Hospital for Children between 2005 and 2015. We extracted details regarding allergy diagnosis, each anaesthetic administered and any adverse events or signs of an allergic reaction in the peri-operative period. A convenience sample of patients without any known food allergies was identified from our prospective anaesthesia research database and acted as a control group. We identified 304 food-allergic children and 649 procedures where propofol was administered. Of these, 201 (66%) had an egg allergy, 226 (74%) had a peanut allergy, 28 (9%) had a soybean allergy and 12 (4%) had a legume allergy. These were compared with 892 allergy-free patients who were exposed to propofol. In 10 (3%) allergy patients and 124 (14%) allergy-free patients, criteria for a possible allergic reaction were met. In nine of the food-allergic children and in all the controls valid non-allergic explanations for the clinical symptoms were found. One likely mild allergic reaction was experienced by a child with a previous history of intralipid allergy. We conclude that genuine serious allergic reaction to propofol is rare and is not reliably predicted by a history of food allergy.

AB - Propofol is the most commonly administered intravenous agent for anaesthesia in children. However, there are concerns that the emulsified preparation may not be safe in children with an allergy to egg, peanut, soybean or other legumes. We conducted a retrospective study of children with immunologically confirmed egg, peanut, soybean or legume allergy and who underwent general anaesthesia at Princess Margaret Hospital for Children between 2005 and 2015. We extracted details regarding allergy diagnosis, each anaesthetic administered and any adverse events or signs of an allergic reaction in the peri-operative period. A convenience sample of patients without any known food allergies was identified from our prospective anaesthesia research database and acted as a control group. We identified 304 food-allergic children and 649 procedures where propofol was administered. Of these, 201 (66%) had an egg allergy, 226 (74%) had a peanut allergy, 28 (9%) had a soybean allergy and 12 (4%) had a legume allergy. These were compared with 892 allergy-free patients who were exposed to propofol. In 10 (3%) allergy patients and 124 (14%) allergy-free patients, criteria for a possible allergic reaction were met. In nine of the food-allergic children and in all the controls valid non-allergic explanations for the clinical symptoms were found. One likely mild allergic reaction was experienced by a child with a previous history of intralipid allergy. We conclude that genuine serious allergic reaction to propofol is rare and is not reliably predicted by a history of food allergy.

KW - allergy

KW - paediatric anaesthesia

KW - propofol

KW - retrospective cohort review

UR - http://www.scopus.com/inward/record.url?scp=85065721099&partnerID=8YFLogxK

U2 - 10.1111/anae.14693

DO - 10.1111/anae.14693

M3 - Article

JO - Anaesthesia

JF - Anaesthesia

SN - 0003-2409

ER -