Prick-test evaluation to anaesthetics in patients attending a general allergy clinic.

Full Abstract

BACKGROUND AND OBJECTIVES: To analyse the prevalence of positive prick-tests to all medicaments normally checked in allergy units when a patient is suspected of being allergic to anaesthetics. To establish the degree of agreement between the antecedents of a previous history of an allergic reaction to a medicament and the positive result, or not, to the specific prick-test for the said medicament. METHODS: This was a prospective study, during 2003 and 2004, which analysed 473 patients referred by their doctors to allergy units to make retrospective diagnoses of an allergy to a drug. The prick-test was done using the undiluted drug. All patients were tested for 41 drugs. These include antibiotics, trimethoprim-sulphamethoxazole, non-steroidal anti-inflammatory drugs (NSAIDs) and perioperative drugs (PD): neuromuscular blocking drugs, latex, iodine, local anaesthetics, hypnotics, opioids and coadjuvants. Cohen's Kappa Index was used to determine the degree of agreement. RESULTS: 71.5% of patients studied presented a positive prick-test. The largest number of positive cases was found in antibiotics (56.4%), followed by PD (15.6%), NSAIDs (14.4%) and trimethoprim-sulphamethoxazole (12.7%). Among PD, the highest prevalence of positive prick-tests was found for neuromuscular blocking drugs (5.3%). Agreement between the substance suspected of causing the allergic reaction and the positive prick-test was excellent for penicillin (Kappa = 0.74) and other antibiotics (Kappa = 0.721) and good for NSAIDs (Kappa = 0.47) and iodine (Kappa = 0.54). CONCLUSIONS: The prevalence of patients with positive prick-tests to PD occurred in 15.6% in this prospective cohort. Neuromuscular blocking drugs were found to have the highest prevalence of positive prick-tests. There is positive agreement when the substance responsible for the allergic reaction is suspected, otherwise agreement is low.

Author information

Author/s: Tamayo, E (E); Rodríguez-Ceron, G (G); Gómez-Herreras, J I (JI); Fernández, A (A); Castrodeza, J (J); Alvarez, F J (FJ);

Affiliation: Valladolid University Hospital, Department of Anaesthesiology and Reanimation, Valladolid, Spain.

Journal and publication information

Publication Type: Journal Article

Journal: European journal of anaesthesiology (Eur J Anaesthesiol), published in England. (Language: eng)

Reference: 2006-Dec; vol 23 (issue 12) : pp 1031-6

Dates: Created 2006/10/17; Completed 2007/02/01;

PMID: 16824237, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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