• Br J Anaesth · Jan 2025

    Editorial

    Drug challenge testing: a critical step in the investigation of neuromuscular blocking agent hypersensitivity.

    • Anna Littlejohns, Philip M Hopkins, Sinisa Savic, Anoop Mistry, and Louise Savic.
    • Department of Theatres and Anaesthesia, St James' University Hospital, Leeds, UK. Electronic address: anna.littlejohns@nhs.net.
    • Br J Anaesth. 2025 Jan 10.

    AbstractNeuromuscular blocking agents are a common cause of perioperative hypersensitivity. The sensitivity and specificity of skin tests and in vitro tests in this context have not been determined conclusively, which poses a barrier to accurate diagnosis. Use of challenge testing represents a promising development in this field and a key tool in confirming tolerance to an alternate neuromuscular blocking agent for use in future anaesthesia. However, its use is currently limited to specialised centres, and a standardised approach to testing has not yet been established. This article summarises the role of challenge testing to neuromuscular blocking agents and highlights the advantages and disadvantages of the different approaches.Copyright © 2024 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

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