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British Journal of Anaesthesia, Vol 82, Issue 5 770-773, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia

CASE REPORTS

Failure to prevent an anaphylactic reaction to a second neuromuscular blocking drug during anaesthesia

M. M. Fisher, D. Merefield and B. Baldo
Departments of Anaesthesia and Medicine, University of Sydney, Sydney, Australia; Intensive Therapy Unit, Royal North Shore Hospital of Sydney, Sydney, Australia; Mater Misericordia Hospital, Bundaberg, Queensland, Australia; Molecular Immunology Unit, Kolling Institute of Medical Research, Royal North Shore Hospital of Sydney, Sydney, Australia

Skin testing is used widely to determine the drug responsible for an anaphylactic reaction during anaesthesia. When a neuromuscular blocking drug in incriminated as the cause of a reaction, it is usual for neuromuscular blocking drugs which do not produce positive skin tests to be considered safe for subsequent use during anaesthesia. We describe three patients in whom false negative skin tests led to a second severe anaphylactic reaction to another neuromuscular blocking drug.
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