Egg Allergy and Propofol — FRCA Final MCQ

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EasyPreoperative AssessmentEgg Allergy and PropofolFRCA Final

A 42-year-old woman (ASA I, 70 kg) is scheduled for total abdominal hysterectomy. She has a documented allergy to egg – she develops urticaria and wheeze after eating eggs. Which anaesthetic drug should be used with extreme caution or avoided?

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Correct answer: D — Propofol

Propofol is formulated in soyabean oil and purified egg phospholipid (lecithin). Although the allergenic protein in eggs (ovalbumin in egg white) is different from egg lecithin (egg yolk), there is a theoretical risk of cross-reactivity in patients with severe egg allergy. The risk is very low with isolated egg white allergy, but in patients with demonstrated allergy to eggs (especially those with symptoms beyond mild oral reactions), propofol should be used with caution or an alternative induction agent selected. Anaphylaxis to propofol from egg allergy is documented but rare.

Reference: RCOA – 2023 – Preoperative assessment: allergy; Association of Anaesthetists – 2019 – Anaphylaxis guidelines