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    Anaphylaxis to Rocuronium in Australia & New Zealand

       

    Daniel Jolley.

    9 articles.

    Created October 27, 2019, last updated 6 days ago.


    Collection: 117, Score: 203, Trend score: 0, Read count: 201, Articles count: 9, Created: 2019-10-27 07:39:25 UTC. Updated: 2019-11-08 09:59:20 UTC.

    Notes

    pearl
    1

    In Australia and New Zealand rocuronium is associated with a higher risk of anaphylaxis when compared to vecuronium or the benzylisoquinolinium NMBDs. This is not the case in North America or Europe.

    Daniel Jolley  Daniel Jolley
    pearl
    1

    Cisatracurium has the lowest risk of anaphylaxis of all non-depolarising neuromuscular blocking drugs.

    Daniel Jolley  Daniel Jolley
    summary
    1

    Australia and New Zealand both experience an unusually high incidence of perioperative anaphylaxis, particularly to neuromuscular blocking drugs. The opioid-based anti-tussive pholcodine has been implicated in increasing population hypersensitivity to muscle relaxants.

    Although historically difficult to identify accurate denominator numbers for incidence calculations, more recent data shows that the anaphylaxis risk for rocuronium is particularly high in Australia & New Zealand and may in fact be roughly comparable to the local risk of suxamethonium anaphylaxis, at 1 in 2,000-3,000 exposures.

    Rocuronium also has a higher risk of anaphylaxis than it’s aminosteroid-sibling vecuronium, and up to a ten-times greater risk than the benzylisoquinolinium atracurium (~1 in 22,500, depending on population). Cisatracurium demonstrates the lowest incidence of anaphylaxis (~1 in 50,000).

    Daniel Jolley  Daniel Jolley

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