[Prospective preoperative survey of 300 patients using prick tests with muscle relaxants].

Annales Françaises D'anesthèsie Et De Rèanimation
Y MariaD A Moneret-Vautrin

Abstract

It is now well established that the retrospective diagnosis of anaphylaxis to muscle relaxants may be based on skin prick testing. These tests, which use undiluted solutions of muscle relaxants, are as sensitive, specific and reproducible as intradermal tests for the diagnosis of IgE related adverse reactions to muscle relaxants. The rate of muscle relaxant anaphylaxis (1/1 500 to 1/5 000) justifies its prevention based on a possible latent sensitization. A prospective investigation was carried out in 300 surgical patients scheduled for general anaesthesia. Prick tests were carried out using the 6 available muscle relaxants: suxamethonium, gallamine, alcuronium, pancuronium, vecuronium and atracurium. The wheal the drug might produce was compared with that obtained with codeine phosphate (a histamine releasing drug). Thirty-seven patients (13%) were considered to be atopic; 262 (87%) had undergone a previous anaesthesia. Three percent (n = 11) of tests were positive for atracurium. The wheal produced by atracurium was in favour of non-specific histamine release. One test was found positive for suxamethonium. Confirmation of this probable latent sensitization was unfortunately not possible. There were no other positive skin test...Continue Reading

Citations

Oct 13, 2011·British Journal of Clinical Pharmacology·Natalia HagauDan Longrois
May 18, 2004·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Malcolm M Fisher, Gordon S Doig
Oct 23, 2003·Anesthesia and Analgesia·David L Hepner, Mariana C Castells

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Anaphylaxis

Anaphylaxis is a serious allergic reaction that is rapid in onset and may cause death.