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[Interference between histamine liberation and drugs used in anesthesiology. Prevention and treatment of the complications of histamine liberation].

The authors report the complications associated with the administration of some anaesthetics using propanidide. In one of the controls, premedication using an antihistamine was sufficient to avoid, during a third administration of propanidide, complications which included a fall in blood pressure and which had occurred when the second anaesthetic had been given. In one patient with high plasma histamine concentrations, circulatory arrest occurred during the second and third anaesthetic, despite meclastinum. Only the addition of a glucocorticoid to the premedication made possible an anaesthetic without problems. During a third propanidide anaesthetic given to this same patient, we were able to confirm our hypothesis by a premedication combining meclastinum and a glucocorticoid, despite the high plasma histamine level found. In certain other cases, however, plasma histimine concentration did not increase despite the development of erythema and urticaria of the face and neck. Serious complications were successfully dealt with using a combination of glucocorticoids, adrenaline derivatives and an antihistamine.

Anaphylaxis↗

Histamine-releasing effect of a corticotrophin derivative. I. Histamine-releasing effect of a nonadecapeptide in comparison with that of other histamine liberators.

The histamine-liberating properties of a synthetic polypeptide (an a synthetic polypeptide (an alkylprolyl derivative of beta1-19-corticotrophin) were investigated under a variety of experimental conditions. It was found to be more potent in this respect than Compound 48/80, Melittin and Triton X-100. The degree of cell destruction observed in conjunction with the release of histamine induced by C 44 680-Ba suggests that the mode of action of the substance more closely resembles that of Compound 48/80 than that of Triton.

Adrenocorticotropic Hormone↗

Histamine liberation in surgical patients following administration of neuromuscular blocking drugs.

The effects of five commonly used neuromuscular blocking drugs on histamine liberation were studied in 105 surgical patients. After standard premedication with pethidine and atropine the patients were anaesthetized with thiopental sodium. d-Tubocurarine and succinylcholine caused significant histamine liberation while alcuronium, gallamine, and pancuronium did not appear to exert this effect. d-Tubocurarine seems to liberate histamine by acting directly on the blood cells thus causing a decrease of histamine in the whole blood and an elevation in plasma. On the other hand, the succinylcholine-induced liberation of histamine may be mediated by muscular fasciculations as it causes an elevation of histamine in whole blood and in plasma. No correlation was found between histamine liberation and blood pressure changes. Erythematous skin reactions were the only clinical sign of histamine liberation caused by intravenous administration of the neuromuscular blocking drugs.

Adult↗

[Ketotifen, a selective histamine liberator].

Ketotifen-induced histamine release from isolated rat mast cells is inhibited under conditions of ATP content depletion in the mast cells. The histamine release is a temperature-dependent process and is blocked at a low temperature. It is concluded that ketotifen is a selective histamine liberator. Time course of ketotifen-induced histamine release corresponds with the process of partial cellular uptake of histamine released.

Animals↗

[Massive histamine liberation. Recovery].

The case of a patient is described, in whom the clinical aspect of massive liberation of histamine occured during general anesthesia, including bronchospasm, hypotension, generalized congestion of the skin. The changes could be reversed and the surgical intervention was continued. The course of the operation made necessary a prolongation of anesthesia, and re-administration of all the substances which had been included in the procedure. However, the following administration of these substances was not followed by a new liberation of histamine. Short comments are made in connection with the theoretical aspects of this evolution.

Anesthesia, General↗

[Histamine liberation in vitro or histamine release (HR). Study of the threshold of positivity in allergy to hymenopteran venoms].

The technique of histamine release in vitro (HR) is only usable in diagnosis of hymenoptera venom allergy. The allergen extracts that are supplied for clinical (skin tests) or biological diagnosis contain significant amounts of histamine, falsify the results, especially HR, and reduce significantly the correlation between HR and other biological or cutaneous tests. Dialysis of the allergen extracts significantly improves the sensitivity and specificity of the technique and lowers the threshold of positivity of HR from 30% to 12%. Correlation of HR with other diagnostic parameters:clinical history, specific IgE and skin tests is very significantly improved.

Animals↗

[Comparative study of histamine liberation after administration of anesthetic substances, curare agents and plasma substitutes in man].

The authors studied in 270 volunteers histamine liberation after administration of drugs. Definite histamine liberation was noted after propanidide, pentothal, methohexital, Alfatesine, and also after muscle relaxants including pancuronium bromide. Until now, among all the substances studies, both clinically and in the laboratory, after 4 years, only etomidate, according to their personal experience is not a histamine liberator. Similar results were observed after ketamine, but also after administration of Atosil (Phenergan) fenestil (Dimethendène) and Trasylol (Zymofren). As far as plasma susbtitutes are concerned, the search for mediators of the anaphylactoid and anaphylactic reactions should be considered in a differential way.

Anaphylaxis↗

Probable histamine liberation with atracurium. A case report.

An histaminoid reaction after the administration of thiopentone and atracurium is described. Serial blood sampling showed no evidence of complement activation. Intradermal testing 6 weeks later yielded a positive result with atracurium (1 in 1000), but not with thiopentone. The clinical course of the reaction and the subsequent investigations suggest a direct pharmacological liberation of histamine.

Adolescent↗