Intradermal Drug Testing following Anaphylactoid Reactions during Anaesthesia

Abstract

Intradermal testing of intravenous anaesthetic drugs was performed on 34 patients following acute anaphylactoid reactions during anaesthesia. Twenty-three patients had positive skin tests and 18 of these were positive for a single drug. Muscle relaxants were the drugs implicated most commonly. Intradermal testing is safe and provides useful and often specific positive information, but falsenegative results probably occur.

Anaphylaxis to Muscle Relaxants: An Audit of Ten Years of Allergy Testing at the Royal Adelaide Hospital

“…The most common drug group implicated is muscle relaxants [1][2][3]8,11,[13][14][15][16][17] . The frequency of anaphylaxis with any drug is related to the amount of exposure and the allergenic tendency of that drug.…”

Skin Reactions to Intradermal Neuromuscular Blocking Agent Injections

“…36 This is probably why the performance of skin tests for the diagnosis of sensitization against NMBAs has been considered as excellent by most of the authors. 1,2,5,7,9,[11][12][13]15,17,18,21,37,38 Indeed, the diagnostic value of an intradermal test in patients having presented with a suspected IgE-mediated immediate hypersensitivity reaction during anesthesia was established many years ago using Prausnitz-Kustner testing in human subjects. 11,37,39 Its excellent reproducibility 10 as well as persistence of positivity with time 10,40,41 has also been confirmed.…”