Department of Anesthesia, Medical School, Clínica Universidad de Navarra, Pamplona, Spain.
Allergy. 2013 Jun;68(6):820-2. doi: 10.1111/all.12154. Epub 2013 May 6.
Allergic skin tests have to be performed 4-6 weeks after an allergic anesthetic reaction. Patients with allergic reactions during anesthesia were prospectively included (n = 44). Skin tests were performed in two stages: (i) Stage 1 (S1), 0-4 days after the reaction; and (ii) Stage 2 (S2), 4-8 weeks after. Five (11.5%) surgical procedures were suspended due to the reaction. Positive skin tests were obtained in 25/44 patients (57%). Allergic diagnosis was carried out at S1 in 15/25 (60%) and at S2 in 10/25 (40%). Three patients resulted positive only in S1. Overall agreement among S1 and S2 skin tests was 70.45%. The kappa statistic was 0.41 (P-value = 0.002). Odds ratio of obtaining a false negative in S1 (compared with S2) was 3.33. Early allergological study is useful, could minimize false negatives, but should be considered as a complement to late skin tests.
过敏皮肤测试必须在过敏麻醉反应后 4-6 周进行。前瞻性纳入了麻醉期间发生过敏反应的患者（n=44）。皮肤测试分两个阶段进行：（i）第 1 阶段（S1），在反应后 0-4 天；（ii）第 2 阶段（S2），在反应后 4-8 周。由于反应，有 5 次（11.5%）手术被暂停。在 44 名患者中，有 25 名（57%）获得了阳性皮肤测试。在 S1 时对 15/25 名（60%）和在 S2 时对 10/25 名（40%）进行了过敏诊断。有 3 名患者仅在 S1 时呈阳性。S1 和 S2 皮肤测试之间的总体一致性为 70.45%。kappa 统计值为 0.41（P 值=0.002）。与 S2 相比，在 S1 获得假阴性的可能性是 3.33 倍。早期过敏研究很有用，可以最大限度地减少假阴性，但应被视为晚期皮肤测试的补充。
