Hypereosinophilia-and-Intraoperative-Complications-under-General-Anesthesia-in-Surgical-Patients-Aged-12-Years-or-More-an-Observation

Background: Hypereosinophilia (HE) is a relatively commoner and previously has been shown to be associated with several adverse effects in intraoperative and immediate postoperative period in anesthetic practice. However, recent scientific literature in this aspect is very scarce. Aim: The present study was aimed to assess the frequency of HE and incidences of notable intraoperative adverse events in such patients. Methods: The present study was conducted in a tertiary care teaching hospital during December 2016 to June 2017. Files of all patients aged 12 years and more attending preanesthetic evaluation clinic was screened for the presence of HE. Anesthetic management of these patients was then observed and adverse events like respiratory spasms, urticaria, drug reactions etc noted. Data were presented in absolute numbers and percentage scale. INSTAT software was used for statistical analysis purpose. Results: A total of 1012 patients were included; 74 (7.31%) were having absolute Eosinophil counts (AEC) > 500 x 109/l. Eosinophilia was more among male (58.11%) and significantly more frequent in children than adults (17.39% versus 6.83%; p 0.015). The AEC of hypereosinophilic patients ranged from 502 to 4030 × 109/l. Medicine consultation was taken in two cases while six cases were prescribed antihelminthic and antihistaminic drug by anesthesiologist in preoperative period. The treatment was effective in reducing AEC by an average of 1191.5 × 109/l. Twenty three out of 27 patients who were managed with general anesthesia were observed for HE related complication. No notable complication attributable to HE was found. Conclusion: HE is very common even in adult surgical patients, mostly asymptomatic and idiopathic; HES is however rare. Deworming and antihistaminic treatment was effective in reducing AEC in patients with marked HE. GA with currently used agents appear to be safe and without much adverse effects (if any) in hypereosinophilic patients.