Management of a Parturient with Mast Cell Activation Syndrome: An Anesthesiologist’s Experience

Table 4

Perioperative triggers and treatments.

Type	Stressor	Treatment
Psychological	Anxiety, emotional stress	Pharmacologic, quiet environment
Mechanical	Pressure (tourniquet and BP cuff), friction (tape) surgery (GI tract a rich source of mast cells)	Minimize operative time, optimal positioning,
	Pain	Multimodal analgesia
Pharmacologic	Histamine releasing drugs	Avoid
Temperature	Hypothermia, hyperthermia, change in temperature	Heat maintenance devices, warm environment, warm intravenous and irrigation fluids
Infection	Bacterial, viral, fungal	As necessary
Foods, odors	Histamine-rich foods, odors (food, perfumes)	Avoid, single occupancy room

BP: blood pressure and GI: gastrointestinal.