先說結論
雞蛋過敏患者可以安全地使用 propofol (註)。
前言
昨天我分享了一篇文章，Propofol 在小兒麻醉的應用；有朋友提到最新的科學證據認為 propofol 可以安全地在雞蛋過敏的兒童身上使用，我查了一些資料，列在下面：
不可使用的依據
Miller's Anesthesia 8th edition中，認為雞蛋過敏者不可使用 propofol的依據是以下兩篇文章：
Marik PE: Propofol: therapeutic indications and side-effects, Curr Pharm Des 10:3639-3649, 2004.
Hofer KN, McCarthy MW, Buck ML, Hendrick AE: Possible anaphylaxis after propofol in a child with food allergy, Ann Pharmacother 37:398-401, 2003.
這兩篇文章年代相對較舊。
支持可以使用的證據
Miller 第93章中其實也有提到支持可使用的文獻 (這篇)，他是回溯性蒐集在 1999 ~ 2010 年間，有 IgE-mediated egg and/or soy allergy 又使用過 propofol 的病人。
作者結論：
Despite current Australian labeling warnings, propofol was frequently administered to egg-allergic children. Propofol is likely to be safe in the majority of egg-allergic children who do not have a history of egg anaphylaxis.
2013年的這篇文章，"Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 1: is propofol safe in patients with egg anaphylaxis?"。
結論：
It is concluded that while the use of propofol in patients with simple egg allergy is likely to be safe, previous egg anaphylaxis is a contraindication.
2016年一月份，BJA發表的文章： "No evidence for contraindications to the use of propofol in adults allergic to egg, soy or peanut."
結論：
No connection between allergy to propofol and allergy to egg, soy or peanut was found. The present practice of choosing alternatives to propofol in patients with this kind of food allergy is not evidence based and should be reconsidered.
個人總結
雖然部分國家藥物管制單位仍然將雞蛋過敏列入 propofol 的使用警訊，較新的文章與證據都傾向於支持雞蛋過敏患者可以安全地使用 propofol。(註)
註：本文僅供專業人士參考，臨床使用請遵守各國建議並依臨床狀況專業判斷決定。
參考資料：
1. Miller's Anesthesia 8th edition chapter 93
2. Allergic reactions to propofol in egg-allergic children. (文章連結)
3. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 1: is propofol safe in patients with egg anaphylaxis? (文章連結)
4. No evidence for contraindications to the use of propofol in adults allergic to egg, soy or peanut. (文章連結)
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