Skin testing in the investigation of reactions to intravenous anaesthetic drugs. A prospective trial of XXXX and @entity2899 .

@entity1 @entity5159 @entity2899
Intradermal skin testing is widely used to determine the causative drugs of presumed anaphylactic anaesthetic reactions. This paper sets out to evaluate the usefulness of skin tests, both intradermal and prick testing, in the prediction of anaesthetic reactions. The muscle relaxant drugs @entity2899 and @entity5159 were chosen for study since they are known to produce a high incidence of minor histaminoid reactions. A trial was conducted in 22 female @entity1 about to undergo elective gynaecological surgery for non-malignant conditions. In intradermal tests, positive wheal and flare reactions to one or other relaxant (diluted 1 in 1,000) occurred in 17 @entity1 and reactions to both drugs in 11 @entity1 . Despite this high incidence of positive reactions, none of the @entity1 had received either drug previously, a view confirmed by the negative results of prick testing. Likewise, when anaesthetized for surgery using @entity5159 or @entity2899 allocated randomly, the minor histaminoid manifestations observed showed no correlation whatsoever with the intradermal tests results. The results of the trial, combined with external reports to this centre, indicate that intradermal testing of anaesthetic drugs, particularly muscle relaxants, produces a high incidence of false positive results. This probably reflects their pharmacological activity rather than antigenicity. It is recommended, therefore, that skin testing should be reserved for situations in which there are strong indications from laboratory tests, backed by case history, of immune sensitization.
