• Natalia Hagau, Nadia Gherman-Ionica, Denisa Hagau, Sebastian Tranca, Manuela Sfichi, and Dan Longrois.
• Department of Anaesthesia and Intensive Care, University of Medicine and Pharmacy 'Iuliu Hatieganu' Cluj-Napoca, Romania. hagaunatalia@gmail.com
• Br J Clin Pharmacol. 2012 Mar 1;73(3):460-6.

AimsInternational 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-anaesthetic 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-anaesthetic drugs in order to analyse the prevalence of positive allergy tests to anaesthetics.MethodsThe selected adult patients were tested for 11 anaesthetic drugs using in vivo tests: skin prick (SPT) and intradermal (IDT) tests and in vitro tests: the basophil activation test (BAT) and detection of drug-specific immunoglobulin E (IgE).ResultsThe 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.ConclusionThe prevalence of positive in vivo and in vitro allergy tests to NMBAs is higher in our study population. This could be an argument for pre-operative SPT to NMBAs for the surgical population with reported non-anaesthetic drug allergies. A larger prospective study is needed to validate changes in clinical practice.© 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.

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