Abstract

Isoflurane has caused contact dermatitis in an anaesthetist (1), and dermatitis is common in anaesthetic workers (2). However, there are no prior reports of occupational asthma. We report three cases with occupational asthma, work-related angioedema or dermatitis to isoflurane (1-chloro-2,2,2-
trifluoroethyl difluoromethyl ether) and sevoflurane [fluoromethyl 2,2,2-trifluoro- 1-(trifluoromethyl) ethyl ether] with positive specific bronchial provocation testing. All worked as anaesthetic assistants or nurses in the same hospital.

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Comments

Agent Isoflurane and sevofluorane; anaesthetic gasses Job Anaesthetic assistant and nurse mostly exposed in recovery areas Proof IgE not tested Skin prick test to allergen extract not tested Non specific bronchial reactivity developed post challenge in 3/3; normal before challenge 3/3 Serial peak flow records positive 1/3; equivocal 1/3; not done 1/3 Specific Bronchial Challenge: late reaction to isoflurane and sevoflurane 15 breaths 0.5% (1); late reaction isoflurane alone 18 breaths 0.5% (1); rash and nsbr decline isoflurane alone 18 breaths 0.5% (1); controls no reaction Follow up Better after relocation away from recovering post-op patients exhaling anaesthetic gasses. One had anaphylactic reaction during a general anaesthetic using sevoflurane

4/18/2008