{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T03:25:54Z","timestamp":1791257154133,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2012,2,13]],"date-time":"2012-02-13T00:00:00Z","timestamp":1329091200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2012,3]]},"abstract":"<jats:p><jats:bold>WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT<\/jats:bold><\/jats:p><jats:p>\u2022\u2003International recommendations stipulate not to perform skin tests to a drug in the absence of a clinical history consistent with drug allergy.<\/jats:p><jats:p>\u2022\u2003In 2006, two publications showed that a positive history of non\u2010anaesthetic drug allergy was the only predictive factor for allergy to anaesthetic drugs when the screening was done in a general surgical population.<\/jats:p><jats:p>\u2022\u2003They concluded that their data supported the international recommendations that a prick test to neuromuscular blocking agents (NMBAs) is indicated only among those patients who have a history to an adverse reaction to them, but at the same time in the case of 2.8% of the patients with no history of peri\u2010anaesthetic allergy, the NMBA to which they showed a positive prick test was avoided.<\/jats:p><jats:p><jats:bold>WHAT THIS STUDY ADDS<\/jats:bold><\/jats:p><jats:p>\u2022\u2003The novelty of the study is our approach regarding a selected population (volunteers from a general surgical population with a prior history of immediate type hypersensitivity reaction to non\u2010anaesthetic drugs) in which we performed pre\u2010operative skin tests and<jats:italic>in vitro<\/jats:italic>tests to NMBAs and other anaesthetics.<\/jats:p><jats:p>\u2022\u2003Ten per cent of our selected patients had a positive prick test to NMBAs and the results of the basophil activation test (BAT) agreed with prick tests in 83% of patients. BAT is a test that detects IgE mediated effector cell activation, overcoming the concerns related to skin reactivity at different drug concentrations.<\/jats:p><jats:p>\u2022\u2003Our results could define a special risk group for intra\u2010anaesthesia anaphylaxis, and they might lead to the necessity of changing the existing pre\u2010operative allergy approach.<\/jats:p><jats:p><jats:bold>AIMS<\/jats:bold>International recommendations stipulate not performing screening skin tests to a drug in the absence of a clinical history consistent with that specific drug allergy. Nevertheless, two publications showed that a positive history of non\u2010anaesthetic drug allergy was the only predictive factor for a positive skin test when screening for allergy to anaesthetic drugs was done. We selected from a surgical population 40 volunteers with a prior history of allergy to non\u2010anaesthetic drugs in order to analyse the prevalence of positive allergy tests to anaesthetics.<\/jats:p><jats:p><jats:bold>METHODS<\/jats:bold>The selected adult patients were tested for 11 anaesthetic drugs using<jats:italic>in vivo<\/jats:italic>tests: skin prick (SPT) and intradermal (IDT) tests and<jats:italic>in vitro<\/jats:italic>tests: the basophil activation test (BAT) and detection of drug\u2010specific immunoglobulin E (IgE).<\/jats:p><jats:p><jats:bold>RESULTS<\/jats:bold>The prevalence for the positive SPT and IDT was 1.6% and 5.8% respectively. The result of flow cytometry agreed with the SPT in five out of seven positive SPT (71%). IgEs confirmed two positive SPT with corresponding positive BAT. Ten per cent of the patients had a positive prick test to neuromuscular blocking agents (NMBA). For midazolam none of the SPT was positive, but 11 patients had positive IDT nonconfirmed by BAT.<\/jats:p><jats:p><jats:bold>CONCLUSION<\/jats:bold>The prevalence of positive<jats:italic>in vivo<\/jats:italic>and<jats:italic>in vitro<\/jats:italic>allergy tests to NMBAs is higher in our study population. This could be an argument for pre\u2010operative SPT to NMBAs for the surgical population with reported non\u2010anaesthetic drug allergies. A larger prospective study is needed to validate changes in clinical practice.<\/jats:p>","DOI":"10.1111\/j.1365-2125.2011.04112.x","type":"journal-article","created":{"date-parts":[[2011,10,11]],"date-time":"2011-10-11T15:45:23Z","timestamp":1318347923000},"page":"460-466","source":"Crossref","is-referenced-by-count":6,"title":["Is a positive history of non\u2010anaesthetic drug allergy a predictive factor for positive allergy tests to 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