title: Intradermal skin testing in the investigation of suspected anaphylactic reactions during anaesthesia--a retrospective survey.
abstract: An anaphylactic reaction is a rare, but severe anaesthetic complication. In this retrospective survey we report on patients with a severe suspected anaphylactic reaction during anaesthesia and the investigation with intradermal skin testing of these suspected anaphylactic reactions. In the patients with an anaphylactic reaction to neuromuscular blocking drugs, the subsequent anaesthetic history was examined. Sixty-five patients suffered a suspected anaphylactic reaction between 1976 and 2001. In 47 patients skin testing was performed and 43 of these patients had positive skin tests: neuromuscular blockings drugs and succinylcholine more specifically, were the most frequently incriminated drugs. After the anaphylactic reaction 19 patients had surgery on 26 occasions with the use of a skin-test-negative neuromuscular blocking drug; no problems occurred. Skin testing proved to be a reliable tool to investigate suspected anaphylactic reactions during anaesthesia and to guide the future use of neuromuscular blocking drugs.
authors.affiliation: Department of Anesthesie en Reanimatie, Sint-Elisabeth Hospital, Rubensstraat 166, 2300 Turnhout, Belgium. filiep.soetens@village.uunet.be
authors.forename: F M
authors.initials: FM
authors.lastname: Soetens
authors.forename: Fr J
authors.initials: FJ
authors.lastname: Smolders
authors.forename: H C
authors.initials: HC
authors.lastname: Meeuwis
authors.forename: A G
authors.initials: AG
authors.lastname: Van der Donck
authors.forename: P H
authors.initials: PH
authors.lastname: Van der Aa
authors.forename: M A
authors.initials: MA
authors.lastname: De Vel
authors.forename: M J
authors.initials: MJ
authors.lastname: Vanhoof
authors.forename: M A
authors.initials: MA
authors.lastname: Soetens
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000707:Anaphylaxis / Q000175:diagnosis* / Q000453:epidemiology; D000758:Anesthesia / Q000009:adverse effects*; D000777:Anesthetics / Q000009:adverse effects*; D002648:Child; D016208:Databases, Factual; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009467:Neuromuscular Depolarizing Agents / Q000009:adverse effects; D012189:Retrospective Studies; D012882:Skin Tests; D013390:Succinylcholine / Q000009:adverse effects
chemical_list: D000777:Anesthetics; D009467:Neuromuscular Depolarizing Agents; D013390:Succinylcholine