Timing of skin testing after a suspected anaphylactic reaction during anaesthesia.
BACKGROUND
A delay of 4 to 6 weeks after a suspected anaphylactic reaction has commonly been recommended before performing skin testing. However, sometimes surgery cannot be delayed, and investigation must be done earlier. Recent recommendations suggest that skin testing can be performed immediately after a reaction.


METHODS
We describe three cases in which skin testing was performed within 3 weeks after the suspected anaphylactic reaction. A literature review was undertaken to evaluate cases where skin testing was performed within 3 weeks of a suspected anaphylactic reaction during anaesthesia.


RESULTS
Review of the literature did not give a definite answer to the optimal timing of skin testing after a suspected anaphylactic reaction during anaesthesia.


CONCLUSIONS
Only positive skin tests can be taken into account, and there is little safety data to provide confidence in early skin testing. A protocol of how to act if urgent surgery is necessary is suggested.
Department of Anaesthesia, AZ Turnhout, Campus Sint-Elisabeth, Belgium. filiep.soetens@skynet.be
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F
Soetens
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Rose
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M
Fisher
D000368:Aged; D000707:Anaphylaxis / Q000175:diagnosis*; D000758:Anesthesia / Q000009:adverse effects*; D000777:Anesthetics / Q000009:adverse effects*; D019645:Arthroplasty, Replacement, Knee; D002277:Carcinoma / Q000601:surgery; D002408:Catheters, Indwelling / Q000009:adverse effects; D003082:Colectomy; D004342:Drug Hypersensitivity / Q000175:diagnosis*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008479:Mediastinal Neoplasms / Q000601:surgery; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects; D011237:Predictive Value of Tests; D012086:Reoperation; D012882:Skin Tests / Q000379:methods*; D013997:Time Factors
D000777:Anesthetics; D003473:Neuromuscular Nondepolarizing Agents