Sensitivity to Intravenous Anaesthetics: A Report of Three Cases

Patients with a presumptive diagnosis of an acute anaphylactoid reaction to anaesthesia were investigated to determine the cause of the reaction and the drug responsible by intradermal testing, patch and prick testing, sequential complement measurement, passive transfer testing and challenge. The most valuable information was provided by intradermal testing and a diagnosis could be made in 150 of 165 patients. When anaphylactoid reactions to anaesthetic drugs occur, intradermal testing one month after the reaction and sequential complement measurements in the immediate post reaction period will enable the diagnosis to be established in the majority of cases. Intradermal testing is of no value for trivial reactions or reactions to colloid solutions or contrast media.

Section: Discussionmentioning

confidence: 95%

The Diagnosis of Acute Anaphylactoid Reactions to Anaesthetic Drugs

Fisher

1981

“…Direct challenge has been used but is dangerous (Barjenbruch andJones 1962, Fisher 1978). Leucocyte challenge tests (Dundee et al 1974) and basophil degranulation tests (Fox, Wilson and Rabow 1971) have been used but require special expertise and may also be susceptible to error due to direct histamine release. Changes in serum complement have been used to identify the nature of the reaction Thornton 1976) but these changes give no help as to the drug responsible.…”

Section: Discussionmentioning

confidence: 99%

Intradermal Testing in the Diagnosis of Acute Anaphylaxis during Anaesthesia — Results of Five Years Experience

Fisher

1979

Intradermal testing has been used in the diagnosis of acute anaphylactic reactions during anaesthesia in 51 patients. Positive results occurred in 32 pa tients and confirmation was possible in 26. Only in one case did a combination of history and intradermal testing not give a diagnosis. Nine of the negative results were confirmed. Intradermal testing is of no value in the diagnosis of reactions to local anaesthetics or colloids but has great value in determining the cause of reactions due to induction agents or muscle relaxants if performed under controlled conditions. It is safe, and requires no expertise in performance or in terpretation.

“…As regards in vitro tests, Dundee et al (1974) used the leucocyte challenge technique (the patients leucocytes release histamine when challenged with the drug), and Fox, Wilkinson and Rabow (1971) used the indirect basophil degranulation technique to confirm their cases.…”

Section: Discussionmentioning

confidence: 99%

Thiopentone Anaphylaxis—Case Report

1975