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British Journal of Anaesthesia, 2001, Vol. 86, No. 5 678-682
© 2001 The Board of Management and Trustees of the British Journal of Anaesthesia

Rocuronium: high risk for anaphylaxis?

M. Rose1 and M. Fisher1,2

1Royal North Shore Hospital of Sydney, St Leonards, NSW, Australia. 2Department of Anaesthesia, University of Sydney, Sydney, Australia*Corresponding author: Intensive Therapy Unit, Royal North Shore Hospital, Pacific Highway, St Leonards, NSW 2065, Australia

Patients suspected of anaphylaxis during anaesthesia have been referred to the senior author’s clinic since 1974 for investigation. Since release of rocuronium on to the worldwide market, concern has been expressed about its propensity to cause anaphylaxis. We identified 24 patients who met clinical and laboratory (intradermal, mast cell tryptase and morphine radioimmunoassay) criteria for anaphylaxis to rocuronium. The incidence of rocuronium allergy in New South Wales, Australia has risen in parallel with sales, while there has been an associated fall in reactions to other neuromuscular blocking drugs. Data from intradermal testing suggested that rocuronium is intermediate in its propensity to cause allergy in known relaxant reactors compared with low-risk agents (e.g. pancuronium, vecuronium) and higher-risk agents (e.g. alcuronium, succinylcholine).

Br J Anaesth 2001; 86: 678–82


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