Tryptase levels after suxamethonium administration and defibrillation

Background: A more than threefold increase in tryptase, when comparing with the control sample, strengthens the diagnosis of anaphylaxis. Trauma, coronary ischaemia and non-IgE-mediated reactions to several medications have been shown to cause more than threefold rise in tryptase levels. The aim of our study was to examine whether suxamethonium or defibrillation could lead to a more than threefold increase in tryptase in the absence of signs of anaphylaxis. Methods: S-tryptase was measured in 50 patients who had general anaesthesia with either pentothal and suxamethonium before electro convulsive therapy (ECT) to treat depression (n=31) or propofol before electro conversion to treat atrial fibrillation (n=19). Blood samples were collected minutes before and 1 h after the procedures. Results: Tryptase values did not differ significantly before and after the procedures. Conclusion: Tryptase levels do not increase in patients undergoing elective defibrillation or ECT with the administration of suxamethonium, in absence of symptoms of anaphylaxis.