Perioperative Allergy Network

This is a multidisciplinary network created by BSACI, the Association of Anaesthetists and the British Society for Immunology Clinical Immunology Professional Network (CIPN). We are also endorsed by the Royal Colleges of Anaesthetists, Pathology and Physicians. The network officially launched on 29th March 2023 and has already demonstrated its reach and impact with two key outputs.

The first is a statement in response to the MRHA withdrawal of pholcodine-containing products due to the risk of neuromuscular blocking agent (NMBA) allergy during anaesthesia. The recommendation that patients be screened for prior pholcodine use had unintended consequences, generating concern that NMBAs should be avoided in patients who have used pholcodine. Our statement, endorsed by the Association and Royal College of Anaesthetists, BSACI and CIPN, clarified that screening was not required and is of no practical benefit. In conjunction with this statement, the network codesigned a patient leaflet with Anaphylaxis-UK to provide patients with information and reassurance about their allergy risk during anaesthesia.

The second output is an addendum to the recently updated Resus Council UK guidelines on management of anaphylaxis. These guidelines steer away from the use of intravenous epinephrine and recommend the intramuscular route. Whilst this is appropriate for the vast majority of patients, this is not the case in the perioperative setting. Here, patients have intravenous access, are fully monitored, and are under the care of an anaesthetist trained in the administration of intravenous epinephrine. In such circumstances, low dose, incremental dosing of epinephrine represents ideal management, allowing much smaller doses to be administered with more rapid effect. This addendum is under stakeholder review and will be published later in the year.

In other news, the network held its first multidisciplinary seminar on May 25th. This event sold out and will be the first of many such opportunities for anaesthetists, allergists and immunologists to share experience and learnings, in order to improve care for patients who suffer perioperative anaphylaxis.

To find out more about the network and join up, visit our www.bsaci.org/about-bsaci/bsacicouncil-and-executive/bsaci-subcommittees/ perioperative-allergy-network/ today!