Adverse Drug Reactions and Anaesthesia: A Narrative Review

Abstract

Adverse drug reactions are defined as the effects created by drugs producing unintended or noxious response in doses normally used for prophylaxis, diagnosis or therapy of diseases. Adverse drug reactions under anaesthesia occur by a number of mechanisms and several risk factors are often involved. The overall incidence of adverse drug reactions to anaesthetic drugs ranges between 1 in 10,000 and 1 in 20,000. Electronic databases were searched to obtain the relevant literature with keywords related to adverse drug reactions and anaesthesia. Total 110 articles were reviewed, bibliography cross-checked and relevant literature was included. This article discusses about the adverse drug reactions to various anaesthetic as well as non anaesthetic drugs used intraoperatively. Anaphylaxis under anaesthesia, its pathophysiology, clinical and laboratory diagnosis, management and prevention has also been discussed in detail. Allergic drug reactions and anaphylaxis in the operating room often presents unique diagnostic concerns as the early signs of anaphylaxis are often masked under general anaesthesia. The use of surgical drapes and use of multiple potential allergen drugs under anaesthesia also make the diagnostic process difficult. Thus, an adequate knowledge, understanding, vigilance and proper documentation with reporting in case of an event is warranted by the attending anaesthesiologist for a good perioperative outcome with decreased morbidity and mortality.