Abstract
Chemonucleolysis is a painful procedure which requires anesthesia. In addition, chymopapain, an enzymatic substance extracted from the latex of the unripe papaya, is antigenic. In approximately 0.5% of cases, chymopapain chemonucleolysis (CN) produces anaphylactic shock. For these reasons, CN requires the presence of an anesthesiologist experienced in radiologic procedures and capable of intervening in case of anaphylactic shock [1, 4, 12].
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Agre K, Wilson RR, Brim M, McDermott DJ (1984) Chymodiactin postmarketing surveillance. Demographic and adverse experience data in 29,075 patients. Spine 9: 479–485
Bernstein DI, Gallagher JS, Ulmer A, Bernstein IL (1985) Prospective evaluation of chymopapain sensitivity in patients undergoing chemonucleolysis. J Allergy Clin Immunol 76: 458–465
Bouillet R (1983) Complications du traitement de la hernie discale. Acta Orthop Belg 49: 49–76
Chymodiactin postmarketing surveillance data (1986) Interim report, May 1986. Smith Laboratories, Northbrook, IL, U.S.A., Laboratoire Armour-Montagu, Levallois-Perret, France
Cornaille G, Leynadier F, Modiano, Dry J (1985) Gravité du choc anaphylactique chez les malades traités par bêta-bloqueurs. Presse Méd 14: 790–791
Cornaille G, Guerin B, Leynadier F, Menkes CJ, Dry J (1987) Tests cutanés et immunoglobulines E spécifiques à la chymopapain après chimionucléolyse. Presse Méd 16: 881–884
Grammer LC, Ricketti AJ, Schafer MF, Patterson R (1984) Chymopapain allergy: case reports and identification of patients at risk for chymopapain anaphylaxis. CL Orthop Relat Res 188: 139–143
Hall BB, McCulloch JA (1983) Anaphylactic reactions following the intradiscal injection of chymopapain under local anesthesia. J Bone Joint Surg [Am] 65 g: 1215–1219
Kahn M, Clement PH, Charriaud A, Jorrot JC (1983) L’anesthésie au cours des chimionucléolyses pour hernies discales. Cah Anesthésiol 31: 301–302
Kapsalis AA, Stern IJ, Bornstein I (1978) Correlation between hypersensitivity to parenteral chymopapain and the presence of IgE antichymopapain antibody. Clin Exp Immunol 33: 150–158
Korinek AM, Viars P (1987) Choc anaphylactique et anaphylactoide. In: Korinek AM, Viars P (eds) Infectiologie, allergologie en anesthésie réanimation. Cours supérieur d’anesthésie et de réanimation. Editions Arnette, Paris, pp 47–64
Laxenaire MC, Gilet B, Moneret-Vautrin DA (1985) Anesthésie pour chimionucléolyse à la chymopapaine. Symp Int Alternatives in Spinal Surgery, June 1718, Paris
Laxenaire MC, Moneret-Vautrin DA, Vervloet D, Alazia M, Francois G (1985) Accidents anaphylactoides graves peranesthésiques. Ann Fr Anesth Reanim 4: 30–46
Levy JH, Roizen MF, Morris JM (1986) Anaphylactic and anaphylactoid reactions. A review. Spine 11: 282–291
McCulloch JA, Canham WD, Dolovich J (1985) Skin tests for chymopapain allergy. Ann Allergy 55: 609–611
McDermott DJ, Agre K, Brim M, Demma FJ, Nelson J, Wilson RR, Thisted RA (1985) Chymodiactin in patients with herniated lumbar intervertebral disc(s). An open-label, multicenter study. Spine 10: 242–249
Moneret-Vautrin DA, Laxenaire MC, Mouton C, Widmer S, Pupil P (1985) Modification de la réactivité cutanée dans l’anaphylaxie aux myorelaxants et hypnotiques, après administration d’anti-H 1, d’anti-H 2 et de tritoqualine. Ann Fr Anesth Reanim 4: 225–230
Moneret-Vautrin DA, Benoist M, Laxenaire MC, Croizier A, Gueant JL (1985) Allergie à la chymopapaine: intérêt de tests prédictifs avant chimionucléolyse. Ann Fr Anesth Reanim 4: 313–315
Moneret-Vautrin DA, Mouton C, Laxenaire MC, Roland J, Aussedat P, Occelli G, Gerard H (1986) Détection d’une sensibilisation à la chymopapaine. Bilan chez 111 candidats à la chimionucléolyse. Sem Hop Paris 62: 3499–3504
Moss J (1985) Use of prophylactic combined H I and H 2 antagonists reduces mortality in chymopapain anaphylaxis. Ann Fr Anesth Reanim 4: 221–224
Noury D, Lavenac G, Milon D, Sauvage J, Bodin JM, Saint-Marc C (1984) Neuroleptanalgésie pour la nucléolyse chimique. Cah Anesthésiol 32: 397–401
Roucoules J, Thurel C, Bard M, Laredo JD (1985) Le point sur la nucléolyse discale. In: Seze S de, Ryckewaert A, Kahn MF, Guerin C (eds) L’actualité rhumatologique. Expansion Scientifique, Paris, pp 274–282
Schaffer J, Piepenbrock S (1984) Chemonucleolysis. General or local anesthesia. Br J Anaesth 56: 1306
Troisier O, Gozlan E, Durey A, Rodineau J, Gounot-Halbout MC, Pelleray B (1980) Traitement des lombo-sciatiques par injection intra-discale d’enzymes proteolytiques (nucleolyse). Nouv Press Med 9: 227–230
Tsay YG, Jones R, Calenoff E, Sun J, Arndt L, Crispin B, McDermott D, Stern I (1984) Chymopapain-induced hypersensitivity following chemonucleolysis. Spine 9: 769–771
Tsay YG, Jones R, Calenoff E, Sun J, Arndt L, Crispin B, Rock H (1984) A preoperative chymopapain sensitivity test for chemonucleolysis candidates. Spine 9: 764–768
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1988 Springer-Verlag/Wien
About this chapter
Cite this chapter
des Essarts, MC. (1988). Anesthesia and complications in chymopapain chemonucleolysis. In: Bard, M., Laredo, JD. (eds) Interventional Radiology in Bone and Joint. Springer, Vienna. https://doi.org/10.1007/978-3-7091-8948-1_4
Download citation
DOI: https://doi.org/10.1007/978-3-7091-8948-1_4
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-8950-4
Online ISBN: 978-3-7091-8948-1
eBook Packages: Springer Book Archive