{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:32:07Z","timestamp":1777944727231,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2024,11,16]],"date-time":"2024-11-16T00:00:00Z","timestamp":1731715200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Perioperative Practice"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:p>Patients with allergy to multiple drugs who have experienced anaphylaxis multiple times present a significant challenge in perioperative management. This report presents a 27-year-old female patient diagnosed with cholelithiasis scheduled for cholecystectomy. The patient has a history of adverse reaction to multiple drugs, including Amoxicillin\/Clavulanic acid, Cefpodoxime, Levofloxacin and two additional drugs (one analgesic and the other multivitamin) each resulting in symptoms suggestive of anaphylaxis on separate occasions. However, the patient has demonstrated tolerance to Amikacin and Paracetamol on several occasions. Given the patient\u2019s drug hypersensitivity state, the patient\u2019s anaesthetist sought clearance for use of anaesthetic drugs and disinfectants prior to surgery. Comprehensive skin testing was conducted for the same, and all drugs tested negative. The outcomes of this testing guided the selection of anaesthesia agents, ensuring safe perioperative care. Subsequently, surgery was performed, using Succinylcholine, Propofol, Rocuronium, Atropine and Neostigmine for general anaesthesia and Chlorhexidine for disinfection, and the postoperative period was uneventful. This case highlights the significance of preoperative assessment and drug testing in patients with a history of drug allergies or anaphylaxis to multiple drugs, to prevent any perioperative complications.<\/jats:p>","DOI":"10.1177\/17504589241299632","type":"journal-article","created":{"date-parts":[[2024,11,16]],"date-time":"2024-11-16T07:16:11Z","timestamp":1731741371000},"page":"167-170","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Skin testing \u2013 A valued tool for assessing adverse reactions to anaesthetic agents in patients allergic to multiple drugs: A case report from a secondary-level hospital"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6766-6830","authenticated-orcid":false,"given":"Taha Ashraf","family":"Qureshi","sequence":"first","affiliation":[{"name":"JLNM Hospital Srinagar, Srinagar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muzima","family":"Jeelani","sequence":"additional","affiliation":[{"name":"JLNM Hospital Srinagar, Srinagar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad","family":"Naveed","sequence":"additional","affiliation":[{"name":"JLNM Hospital Srinagar, Srinagar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arifa","family":"Ameen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, JLNM Hospital Srinagar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afaq","family":"Jalali","sequence":"additional","affiliation":[{"name":"Department of Medicine, JLNM Hospital Srinagar, Srinagar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hadeeqa","family":"Aejaz","sequence":"additional","affiliation":[{"name":"Government Medical College, Srinagar, Srinagar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tabasum","family":"Shafi","sequence":"additional","affiliation":[{"name":"Department of Immunology &amp; Molecular Medicine, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ayaz","family":"Gull","sequence":"additional","affiliation":[{"name":"Department of Immunology &amp; Molecular Medicine, Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Srinagar, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,11,16]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)60305-5"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/all.12142"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/69.4.404"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaip.2022.08.049"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijaai.ijaai_36_23"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/2045-7022-3-3"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.4103\/ijaai.ijaai_34_22"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.17085\/apm.20089"},{"key":"e_1_3_2_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2017.06.003"},{"key":"e_1_3_2_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2044.1983.tb10453.x"},{"issue":"1","key":"e_1_3_2_12_1","article-title":"Chlorhexidine allergy in the perioperative setting: A narrative review","volume":"123","author":"Michael MR","year":"2019","unstructured":"Michael MR, Garcez T, Savic S, Garvey LH 2019 Chlorhexidine allergy in the perioperative setting: A narrative review British Journal of Anaesthesia 123 (1) e95\u2013e103","journal-title":"British Journal of Anaesthesia"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2022.10.006"},{"key":"e_1_3_2_14_1","first-page":"391","volume-title":"Journal of Allergy and Clinical Immunology","volume":"117","author":"Sampson HA","year":"2006","unstructured":"Sampson HA, Mu\u00f1oz-Furlong A, Campbell RL, Adkinson NF, Bock SA, Branum A, et al 2006 Second symposium on the definition and management of anaphylaxis: Summary report \u2013 Second national institute of allergy and infectious disease\/food allergy and anaphylaxis network symposium Journal of Allergy and Clinical Immunology 117 (2) 391\u2013397"},{"key":"e_1_3_2_15_1","first-page":"449","article-title":"Risks and benefits of preoperative high-dose methylprednisolone in surgical patients: A systematic review","volume":"23","author":"Sauerland S","year":"2000","unstructured":"Sauerland S, Nagelschmidt M, Mallmann P, Neugebauer EA 2000 Risks and benefits of preoperative high-dose methylprednisolone in surgical patients: A systematic review Surgical Endoscopy 23 449\u2013461","journal-title":"Surgical Endoscopy"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2011.01.038"},{"key":"e_1_3_2_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anai.2010.08.002"},{"key":"e_1_3_2_18_1","volume-title":"Tintinalli\u2019s Emergency Medicine: A Comprehensive Study Guide","author":"Tintinalli JE","year":"2010","unstructured":"Tintinalli JE 2010 Tintinalli\u2019s Emergency Medicine: A Comprehensive Study Guide (9th Edition) New York, McGraw-Hill","edition":"9"}],"container-title":["Journal of Perioperative Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17504589241299632","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17504589241299632","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17504589241299632","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T08:06:45Z","timestamp":1777709205000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17504589241299632"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,16]]},"references-count":17,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1177\/17504589241299632"],"URL":"https:\/\/doi.org\/10.1177\/17504589241299632","relation":{},"ISSN":["1750-4589","2515-7949"],"issn-type":[{"value":"1750-4589","type":"print"},{"value":"2515-7949","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,16]]}}}