In all serious reactions adrenaline should be given intravenously. Remember that adrenaline only lasts a short time and repeated doses may be necessary. Adrenaline is the recommended drug as it will reverse the vasodilation and treat the bronchospasm. Although it has little effect in the emergency situation, it may prove useful with persistent bronchospasm. Salbutamol may also be used for this indication.
Antihistamines are of little use.
After the immediate crisis has been managed the patient should be carefully observed in a suitable area of the hospital, for example the intensive care unit or recovery room. They are likely to need continued management on the above lines for some hours. The patient should be warned of the problem that developed during the anaesthetic and the drugs used recorded. The patient will then be able to explain the problem to any anaesthetist they meet in the future. In some centres the patient can be tested to assess which drug caused the reaction, however this is not generally available.