[Value of skin tests for the choice of a neuromuscular blocking agent after an anaphylactic reaction].
We report a grade III allergic hypersensitivity reaction occurring in a 72-year-old patient immediately after anaesthesia induction. Anaphylaxis to cisatracurium was diagnosed on clinical symptoms, biological tests and positivity of the cutaneous tests to this neuromuscular blocking agent. Five days after this allergological assessment, rocuronium, a muscle relaxant for which skin tests appeared negative was used during surgery without adverse effects. The authors underline the value of a detailed allergological assessment to identify the pathophysiologic mechanism, the culprit drug and to propose a safer alternate drug that might be used.
Dewachter
P
P
Service d'anesthésie-réanimation chirurgicale, CHU hôpital central, 29 avenue du Maréchal-de-Lattre-de-Tassigny, 54035 Nancy cedex, France. pascale.dewachter@wanadoo.fr
Mouton-Faivre
C
C
Pertek
J-P
JP
Boudaa
C
C
Mertes
P-M
PM
D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D000707:Anaphylaxis / Q000139:chemically induced*; D000732:Androstanols / Q000008:administration & dosage*; D001279:Atracurium / Q000008:administration & dosage / Q000009:adverse effects* / Q000031:analogs & derivatives*; D001986:Bronchial Spasm / Q000139:chemically induced; D004342:Drug Hypersensitivity / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007431:Intraoperative Complications / Q000139:chemically induced*; D008297:Male; D003473:Neuromuscular Nondepolarizing Agents / Q000008:administration & dosage / Q000009:adverse effects*; D012004:Rectal Neoplasms / Q000601:surgery; D000077123:Rocuronium; D012811:Sigmoid Neoplasms / Q000601:surgery; D012882:Skin Tests
D000732:Androstanols; D003473:Neuromuscular Nondepolarizing Agents; D001279:Atracurium; C101584:cisatracurium; D000077123:Rocuronium