No Evidence for Contraindications to the Use of Propofol in Adults Allergic to Egg, Soy, or Peanut

摘要

Because the current formulations of propofol contain an emulsion that incorporates egg lecithin and soybean oil, there is a concern that propofol may be a potential trigger of allergic reactions in patients allergic to egg, soy, or peanut. However, with the exception of 6 case reports, the literature is devoid of evidence linking the 2 types of allergies. The objectives of the current study were to explore the frequency of propofol allergy and to assess whether patients with specific immunoglobulin E (IgE) to egg, soy, or peanut tolerated propofol. Study A determined the frequency of propofol allergy in 273 patients systematically studied for suspected perioperative allergic reactions. Of these, 153 had exposure to propofol and underwent skin tests and intravenous provocation. Study B retrospectively investigated propofol exposure and tolerance in 520 adult patients with a positive specific IgE to egg, soy, or peanut. Of the 153 propofol-exposed patients investigated in study A, 4 (2.6%) were given a diagnosis of propofol allergy. Of these, 3 tested positive only on intravenous provocation. None of the4 patients had allergic symptoms when eating egg, soy, or peanut, and none had discernible levels of specific IgE to egg or soy in their serum. Moreover, in study B, no signs of allergic reactions to propofol in 171 retrieved anesthetic charts from 99 patients with specific IgE to egg, soy, or peanut were identified, hi summary, no connection between allergies to propofol and allergies to egg, soy, or peanut was detected.