Korean J Anesthesiol.  2018 Aug;71(4):296-299. 10.4097/kja.d.18.27156.

Intradermal skin tests for rocuronium and cisatracurium in patients with a history of allergy: a retrospective study

• Kim YY
• Kim IT
• Shin SI
• Yim SM

• KMID: 2418528
• DOI: http://doi.org/10.4097/kja.d.18.27156

Abstract

BACKGROUND
Neuromuscular blocking agents (NMBAs) are a leading cause of perioperative anaphylaxis. However, the performance of systematic screening skin tests to detect reactions for NMBAs prior to general anesthesia is not recommended. We retrospectively examined intradermal tests (IDTs) for rocuronium and cisatracurium in patients with a history of allergy.
METHODS
We reviewed the records of patients who underwent IDTs for NMBAs between January 1 and December 31, 2016. We analyzed the patients' allergy histories and skin test results for NMBAs.
RESULTS
The overall prevalence of positive IDTs was 5.8% (26/451), and there was no significant difference in prevalence among allergy types (P = 0.655). In logistic regression analysis, there was no allergy history that had a significant effect on positive IDT for NMBAs.
CONCLUSIONS
We found no association between allergy history and positive skin test for NMBAs. Therefore, a systematic screening test for NMBAs or other anesthetic agents before anesthesia is not considered necessary even in patients with an allergy history.

Keyword

Intradermal test; Neuromuscular blocking agents; Perioperative anaphylaxis

MeSH Terms

Anaphylaxis
Anesthesia
Anesthesia, General
Anesthetics
Humans
Hypersensitivity*
Intradermal Tests
Logistic Models
Mass Screening
Neuromuscular Blocking Agents
Prevalence
Retrospective Studies*
Skin Tests*
Skin*
Anesthetics
Neuromuscular Blocking Agents