Anaphylactic/anaphylactoid reactions to anaesthetic and associated agents. Skin prick tests in aetiological diagnosis.

Fifty-one patients were referred in one year (1992) for investigation of immediate type anaphylactic/anaphylactoid reactions during anaesthesia. Skin prick tests were made with 23 anaesthetic and associated agents in the concentrations used clinically. Definite or probable causes were identified by immediate type wealing reactions, supported by the clinical history in 36 of the 46 in whom a diagnosis of anaphylaxis was made. These comprised mainly the neuromuscular relaxants, chiefly suxamethonium (18); atracurium (6); gallamine (2); one each alcuronium; pancuronium; vecuronium and tubocurarine, as well as alfentanil (1); Gelofusine (2); cefuroxime (1) and latex (2). The materials for performing the skin prick test are readily available and it can be very helpful in making important aetiological diagnoses.