Prevalence of positive prick test to anaesthetic drugs in the surgical population

Tamayo, Eduardo; Álvarez, Francisco; Rodríguez-Ceron, Gemma; Castrodeza, J.

doi:10.1111/j.1398-9995.2006.01121.x

Cited by 18 publications

(20 citation statements)

References 6 publications

(7 reference statements)

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“…In our study, the prevalence of patients with a positive SPT to NMBAs was higher (10%) than that reported in general population (2.8%-4.65%) [1,6]. Nevertheless, in our study, a high percentage of positive SPTs with a high rate of confirmation through BAT, suggests that a prior history of allergy to non-anaesthetic drugs might predict positive prick tests to anaesthetic drugs.…”

Section: Discussioncontrasting

confidence: 74%

“…Unlike Tamayo et al . we have performed not only SPTs for screening but also IDTs and in vitro tests, IgEs and BAT, to enforce the results of the SPTs [1]. BAT might provide additional information as the technique closely resembles the in vivo pathway leading to symptoms [30].…”

Section: Discussionmentioning

confidence: 99%

“…In 2006 Tamayo et al . found that when screening for allergy to anaesthetic drugs in a surgical population, the only predictive factor for a positive skin prick test (SPT) was a positive history of allergy to non‐anaesthetic drugs [1, 5]. In contrast, in 1999 Porri et al .…”

Section: Introductionmentioning

confidence: 99%

“…Screening tests for anaesthetic drug allergy might nevertheless prove valuable when a group of patients with a defined risk profile is selected. In 2006 Tamayo et al found that when screening for allergy to anaesthetic drugs in a surgical population, the only predictive factor for a positive skin prick test (SPT) was a positive history of allergy to non-anaesthetic drugs [1,5].In contrast,in 1999 Porri et alfound no risk factors (atopy or history of drug allergy) for the positive SPTs when screening for allergy to neuromuscular blocking agents (NMBA) was done in a general population [6]. The progression from a positive SPT to clinical allergy is multifactorial but the presence of a positive test might be proof of latent sensitization, with possible subclinical, minor or major clinical expression [7].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Is a positive history of non‐anaesthetic drug allergy a predictive factor for positive allergy tests to anaesthetics?

Hagău

Gherman-Ionica

Hagau

et al. 2012

Brit J Clinical Pharma

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WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT• International recommendations stipulate not to perform skin tests to a drug in the absence of a clinical history consistent with drug allergy.• In 2006, two publications showed that a positive history of non-anaesthetic drug allergy was the only predictive factor for allergy to anaesthetic drugs when the screening was done in a general surgical population.• They concluded that their data supported the international recommendations that a prick test to neuromuscular blocking agents (NMBAs) is indicated only among those patients who have a history to an adverse reaction to them, but at the same time in the case of 2.8% of the patients with no history of peri-anaesthetic allergy, the NMBA to which they showed a positive prick test was avoided. WHAT THIS STUDY ADDS• The novelty of the study is our approach regarding a selected population (volunteers from a general surgical population with a prior history of immediate type hypersensitivity reaction to non-anaesthetic drugs) in which we performed pre-operative skin tests and in vitro tests to NMBAs and other anaesthetics.• Ten per cent of our selected patients had a positive prick test to NMBAs and the results of the basophil activation test (BAT) agreed with prick tests in 83% of patients. BAT is a test that detects IgE mediated effector cell activation, overcoming the concerns related to skin reactivity at different drug concentrations.• Our results could define a special risk group for intra-anaesthesia anaphylaxis, and they might lead to the necessity of changing the existing pre-operative allergy approach. AIMSInternational recommendations stipulate not performing screening skin tests to a drug in the absence of a clinical history consistent with that specific drug allergy. Nevertheless, two publications showed that a positive history of non-anaesthetic drug allergy was the only predictive factor for a positive skin test when screening for allergy to anaesthetic drugs was done. We selected from a surgical population 40 volunteers with a prior history of allergy to non-anaesthetic drugs in order to analyse the prevalence of positive allergy tests to anaesthetics. METHODSThe selected adult patients were tested for 11 anaesthetic drugs using in vivo tests: skin prick (SPT) and intradermal (IDT) tests and in vitro tests: the basophil activation test (BAT) and detection of drug-specific immunoglobulin E (IgE). RESULTSThe prevalence for the positive SPT and IDT was 1.6% and 5.8% respectively. The result of flow cytometry agreed with the SPT in five out of seven positive SPT (71%). IgEs confirmed two positive SPT with corresponding positive BAT. Ten per cent of the patients had a positive prick test to neuromuscular blocking agents (NMBA). For midazolam none of the SPT was positive, but 11 patients had positive IDT nonconfirmed by BAT. CONCLUSIONThe prevalence of positive in vivo and in vitro allergy tests to NMBAs is higher in our study population. This could be an argument for pre-operative SPT to NMBAs for the surgical popula...

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Section: Discussioncontrasting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Is a positive history of non‐anaesthetic drug allergy a predictive factor for positive allergy tests to anaesthetics?

Hagău

Gherman-Ionica

Hagau

et al. 2012

Brit J Clinical Pharma

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“…A prospective study of surgical patients showed the occurrence of 4.7% who presented a positive prick test to anesthetic drugs [39]. Only prior history of allergy to medications was shown to predict positive prick tests to anesthetic drugs.…”

Section: Discussionmentioning

confidence: 98%

Cross-reactivity of anti-phosphorylcholine antibodies to neuromuscular blockers in a murine model of immunization

Mazzuco

Sato

Vasconcelos

et al. 2007

International Immunopharmacology

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Current awareness: Pharmacoepidemiology and drug safety

2006

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 20 sections: 1 Books, Reviews & Symposia; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Teratogens/fetal exposure; 20 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Prevalence of positive prick test to anaesthetic drugs in the surgical population

Abstract: Prevalence of patients with positive prick tests to anaesthetics occurred in 4.7% of the surgical population.

Cited by 18 publications

References 6 publications

Is a positive history of non‐anaesthetic drug allergy a predictive factor for positive allergy tests to anaesthetics?

Is a positive history of non‐anaesthetic drug allergy a predictive factor for positive allergy tests to anaesthetics?

Cross-reactivity of anti-phosphorylcholine antibodies to neuromuscular blockers in a murine model of immunization

Current awareness: Pharmacoepidemiology and drug safety

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