title: Anaphylaxis during anesthesia - role of skin prick testing in diagnosing multiple sensitivities.
abstract: The true incidence of anaphylactic reactions and their associated morbidity and mortality remain poorly defined. This is due to uncertainties in reporting accuracy and exhaustivity. A 23 years old male developed severe anaphylaxis under general anesthesia with cardiovascular collapse, bronchospasm and angio-edema. He was promptly managed with intravenous Adrenaline, Hydrocortisone, colloid solutions and Promethazine. The temporal relation suggested Atracurium to be the cause. However, skin prick test, performed 8 weeks later, showed a very strong (+++) positive test for Atracurium and mild sensitivity (+) with Suxamethonium. No sensitivity to Nalbuphine, Thiopentone or Pancuronium was noted. The relevant information was endorsed in patient's medical record sheet for his future exposure.
authors.affiliation: Department of Anesthesia & Intensive Care, CMH, Bahawalpur.
authors.forename: Rashad
authors.initials: R
authors.lastname: Siddiqi
authors.forename: Muhammad Azmat
authors.initials: MA
authors.lastname: Khan
authors.forename: Nasser Rashid
authors.initials: NR
authors.lastname: Dar