Propanidid


Short-acting general anesthetic used especially for tooth extractions.
 
Incidence
Very high: 1 out of 500 to 1 out of 700 anesthesias.
 
Severe reactions: 0.007% to 0.13%.
 
Clinical manifestations
General: anaphylactic shock.
 
Respiratory: bronchospasm.
 
Dermatological: various delayed reactions.
 
Digestive: nausea, vomiting, diarrhea.
 
Diagnostic methods
Complement assay at the time of the accident (difficult).
 
Blood histamine measurement at the time of the accident.
 
Mechanisms
Responsibility of solvent: cremophor E.L., which activates the classical or alternative complement pathway, releasing C3a anaphylatoxin and leukocyte migration.

Non-specific histamine release.
 
Management
Prohibited in many countries since 1983.
 
Avoidance.
 

References

  1. Guerrero J, Trevilla J.M, de las Mulas M, Herrera J.C, Malagon F, "Reaccion anafilactica a la propanidida", Rev. Esp. Anesthesiol Reanim., 1985 ; 32 (5): 252-3.
  2. Christmas J.P, "Immune reaction to propanidid", Anaesthesia, 1984 ; 39:
    470-3.

As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.