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Case report demonstrates a severe anaphylactoid reaction to sodium benzoate in an anaesthetized patient, indicating adverse pathways independent of histamine release.
Anaphylactoid reactions are an increasingly frequent complication of general anaesthesia.The frequency may be as high as 1 :5,000 1 in Australia and 1: 1 ,000 in France 2 with relaxants, barbiturate and cremophor based induction agents the major causes.3 • 4 .5 Various pathophysiological mechanisms have been described: true anaphylaxis,2 direct histamine release,2 and activation of the classical and alternate complement pathways.4All of these potential mechanisms involve the release of histamine.We present a case of a severe anaphylactoid reaction to sodium benzoate during anaesthesia in spite of intensive antihistamine pre-treatment and suggest a mechanism by which such reactions can occur.
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Moneret‐Vautrin et al. (1982) studied this question.
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