Allergic and pseudoallergic reactions that occur under anesthesia represent a significant cause of perioperative morbidity and mortality. Histamine has been implicated to be one of the major mediators of such reactions. Recent studies have demonstrated that perioperative histamine release may occur more frequently and with less predictability than previously thought. Rash and hypotension may be important signs of these reactions to anesthetic drugs and adjuvants. However, present evidence suggests that H1- and H2-receptor blockade may be effective in preventing histamine-related symptoms.
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