Skip to main content

Is anesthesia associated with impaired vaccine efficacy?



Vaccination and Anesthesia






Vaccines are broadly classified into two categories, that is, live attenuated (BCG, MMR) or inactivated (IPV).



Rash and fever are common 7–10 days after MMR, parotitis 3 weeks after MMR, and local reactions and fever within 48 h of DtaP/IPV/Hib.



In a survey of anaesthetists by Short and colleagues, 60% of the respondents stated that they would not delay anaesthesia for elective surgery in a recently immunized child, while 40% would postpone for a week for inactive vaccines and 3 weeks for live vaccine.



As a conclusion, misinterpretation of vaccine-related adverse events as postoperative complications may be avoided by respecting a minimal delay between immunization and anaesthesia.



A delay of 48 hours is needed for children immunized with inactivated vaccine. On the other hand, there is no need to delay anesthetic in a child immunized with live vaccine if the child is well at preoperative assessment.



The influence of anaesthesia on various markers of immunity has been assessed in children, showing a decrease in absolute T- and B-lymphocyte counts after surgery that return to preoperative values within hours or days. This may represent the redistribution of immune cells from the peripheral blood to lymphatic tissues or local sites of trauma rather than immunodepression. All studies demonstrate a short-lived and reversible influence on lymphoproliferative responses that return to preoperative values within 24-48 h.
Labels:

Comments

Post a Comment

Popular posts from this blog

power injectable peripherally inserted central catheters

Clinical experience with power injectable peripherally inserted central catheters in intensive care patients     Introduction In intensive care units (ICU), peripherally inserted central catheters (PICC) may be an alternative option to standard central venous catheters, particularly in patients with coagulation disorders or at high risk for infection. Some limits of PICCs (such as low flow rates) may be overcome by the use of power-injectable catheters . Method We have retrospectively reviewed all the power injectable PICCs inserted in adult and pediatric patients in the ICU during a 12-month period, focusing on the rate of complications at insertion and during maintenance. Results We have collected 89 power injectable PICCs (in adults and in children), both multiple and single lumen. All insertions were successful. There were no major complications at insertion and no episodes of catheter-related blood stream infection. Non-infective complications ...
1 comment
Read more

The 12 decision making steps for post dural puncture headache treatment

Treatment decision-making algorithm for postdural puncture headache. 1. When diagnosis is made, all patients should receive supportive measures (reassurance, bed rest, analgesics, hydration, quiet environment). 2. Severity of symptoms should be classified using VAS scale (mild 1–3, moderate 4–6, severe 7–10). 3. Virtually all patients will improve in time even without additional therapy. (dashed lines) 4. Symptoms worsen or fail to resolve within 5 days. 5. Patient preference dictates the choice between pharmacologic (less effective) and epidural blood patch (EBP). 6. In patients with severe symptoms, EBP is strongly suggested. 7. The most common pharmacologic measure is  caffeine  prescription. 8. The failure, worsening, or recurrence of symptoms after pharmacologic measures favors the use of EBP. 9. In addition to EBP, other epidural treatment options can be considered in select patients (eg,  dextran , saline). 10. A period of 24 h should lapse before repeating EBP. 11...
1 comment
Read more

Things to Avoid in Anesthesia for Pregnant with Pulmonary hypertension

Anesthesia for Pregnant woman with Pulmonary Hypertension is a real challenge for anesthesiologist. It is very crucial to remember the pathophysiology of pulmonary hypertension in pregnant women and to avoid some practices that will worsen the cardiac status. 1-Avoid single shot spinal anesthesia. Some authorities consider pulmonary hypertension as absolute contraindication for single shot spinal anesthesia specially in patients with NYHA III ,IV. Spinal anesthesia causes major hemodynamic instability(decrease SVR, decrease VR, decrease in CO) The preferred neuroaxial techniques are (epidural anesthesia and CSE with minimal spinal dose) 2-Avoid PAC. Pulmonary Artery catheters insertion may lead to pulmonary artery rupture or thrombosis. TEE is better cardiac monitor/Arteial line is mandatory. 3-Avoid Nitrous oxide in gas mixture.N2O increase the PVR 4-If MV to be started, avoid High TV and PEEP 5-Avoid Oxytocin Boluses, or rapid administration of Pitocin. Oxytocin causes ...
Post a Comment
Read more