Propofol (2-6 diisopropylphenol) is an alkyl phenol in a lipid vehicle (soybean oil, egg lecithin, glycerol) used in anesthesia.
1.2% of peroperative anaphylactic shocks in France.
Previous drug allergy.
Allergy to muscle relaxants.
Association with atracurium.
General: anaphylactic shock.
Cutaneous: urticaria, angioedema, facial edema, erythema.
Ocular: conjunctival chemosis.
Intradermal skin-tests from 1 µg/ml to 100 µg/ml (1/1000 to 1/10). Positive in most patients with anaphylactic reactions.
Specific IgE (RIA): positive in 10/14 propofol allergic patients.
Leukocyte-specific histamine release: positive in 3/5 propofol allergic patients.
IgE-mediated hypersensitivity in most cases.
Propofol contains 2 isopropyl group that may act as the epitopes.
Do not use propofol in muscle relaxant-allergic patients.
Do not use atracurium with propofol (high frequency of anaphylactoid reactions).