Antihistamine for plasma-substitute and experimental
histamine-induced reactions
It is unclear whether prophylactic antihistamine reduces plasma
substitute and histamine-induced anaphylaxis because the certainty of
evidence is very low (supplement S7d). One trial about prophylactic
antihistamine prior to plasma substitute haemaccel found a 24%
reduction in the incidence of anaphylaxis (statistically significant, CI
not reported, very low certainty).11Lorenz W, Doenicke A,
Dittmann I, Hug P, Schwarz B. Anaphylactoid reactions following
administration of plasma substitutes in man. Prevention of this
side-effect of haemaccel by premedication with H1- and H2-receptor
antagonists. Anaesthesist 1977;26(12):644-648. Another trial of
prophylactic antihistamine prior to intravenous histamine infusion found
that intramuscular H1+H2 receptor-antagonist pre-treatment reduced
reactions (numbers not reported, very low certainty).22Tryba M,
Zevounou F, Zenz M. Prevention of anaphylactoid reactions using
intramuscular promethazine and cimetidine. Studies of a histamine
infusion model. Anaesthesist 1984;33(5):218-223.