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Plasma histamine levels in patients in the course of several standard operations: Influence of anaesthesia, surgical trauma and blood transfusion

Plasmahistaminspiegel bei Patienten im Verlauf von verschiedenen Standardoperationen: Einfluß von Anästhesie, chirurgischem Trauma und Bluttransfusion

  • 1. Adverse Reactions And Histamine Release In Anaesthesia And Surgery
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Summary

A prospective controlled clinical trial was conducted on changes in plasma histamine and catecholamine levels during 5 standard operations. This communication, as the first part of the trial, deals only with the feasibility of such a trial and the changes in plasma histamine levels.

Elevated histamine concentrations corresponding to histamine-release responses of >1 ng/ml occurred in 8 of 25 operations. In an explorative analysis these reponses were associated with distinct phases of anaesthesia or the surgical procedure.

Blood transfusion carried the risk of infusion of “free histamine” into the patient — especially when administered under pressure.

Since during operations “free histamine” enters the circulation with a rather high incidence and may cause harmful effects, premedication with H1-+H2-receptor antagonists seems worth consideration.

Zusammenfassung

Eine prospektive kontrollierte klinische Studie wurde über Veränderungen des Plasmahistamin- und Katecholaminspiegels bei 5 Standardoperationen durchgeführt. Diese Mitteilung, als erster Teil der Studie, zeigt nur die Möglichkeiten auf, eine solche Studie durchzuführen und Veränderungen des Plasmahistaminspiegels nachzuweisen.

Erhöhte Plasmahistaminkonzentrationen, die einer Histaminfreisetzungsreaktion von >1 ng/ml entsprechen, kamen bei 8 von 25 Operationen vor. In einer explorativen statistischen Analyse wurden diese Reaktionen mit bestimmten Phasen der Anästhesie oder des chirurgischen Eingriffs in Verbindung gebracht.

Bluttransfusionen tragen das Risiko in sich, „freies Histamin“ in den Patienten zu infundieren — zumal bei Filterpassage, wenn es unter erhöhtem Druck angewandt wird. Da während Operationen recht häufig „freies Histamin“ in die Zirkulation gelangt und möglicherweise schädigende Wirkungen entfaltet, ist möglicherweise eine Prämedikation mit H1- und H2-Rezeptorantagonisten ratsam.

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Authors and Affiliations

  1. Dept. of Surgery, Division of Theoretical Surgery, Centre of Operative Medicine I, Department of Anaesthesia University of Marburg (Lahn), Robert-Koch-Str. 8, D-3550, Marburg, Federal Republic of Germany

    H. D. Röher, W. Lorenz, H. Lennartz, J. Kusche, W. Dietz, B. Gerdes & J. V. Parkin

  2. Department of Surgical Studies, Middlesex Hospital, London, UK

    H. D. Röher, W. Lorenz, H. Lennartz, J. Kusche, W. Dietz, B. Gerdes & J. V. Parkin

Authors
  1. H. D. Röher
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  2. W. Lorenz
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  3. H. Lennartz
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  4. J. Kusche
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  5. W. Dietz
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  6. B. Gerdes
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  7. J. V. Parkin
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Supported by grant of Deutsche Forschungsgemeinschaft (Lo 199/13-6)

Supported by the Wellcome Trust, London

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Röher, H.D., Lorenz, W., Lennartz, H. et al. Plasma histamine levels in patients in the course of several standard operations: Influence of anaesthesia, surgical trauma and blood transfusion. Klin Wochenschr 60, 926–934 (1982). https://doi.org/10.1007/BF01716949

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  • DOI: https://doi.org/10.1007/BF01716949

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