Department of Anesthesiology and Pain Medicine, Kyung Hee University Hospital, Kyungheedae Road 23, Dongdaemun-Gu, Seoul 02447, Korea.
Medicina (Kaunas). 2020 Aug 7;56(8):394. doi: 10.3390/medicina56080394.
It is recommended that a skin test be performed 4-6 weeks after anaphylaxis. However, there is little evidence about the timing of the skin test when there is a need to identify the cause within 4-6 weeks.
A 57-year-old woman was scheduled to undergo surgery via a sphenoidal approach to remove a pituitary macroadenoma. Immediately after the administration of rocuronium, pulse rate increased to 120 beats/min and blood pressure dropped to 77/36 mmHg. At the same time, generalized urticaria and tongue edema were observed. Epinephrine was administered and the surgery was postponed. Reoperation was planned two weeks after the event. Four days after the anaphylactic episode, rocuronium was confirmed to be the cause by the skin prick test. Cisatracurium, which showed a negative reaction, was selected as an alternative agent for future procedures. Two weeks later, the patient underwent reoperation without any adverse events.
The early skin test can be performed if there is a need even earlier than 4-6 weeks after anaphylaxis.
建议在发生过敏反应后 4-6 周进行皮肤测试。然而，当需要在 4-6 周内确定病因时，皮肤测试的时间很少有证据。
一名 57 岁女性拟通过蝶窦入路接受手术切除垂体大腺瘤。罗库溴铵给药后，心率立即增加至 120 次/分，血压降至 77/36 mmHg。同时，出现全身性荨麻疹和舌水肿。给予肾上腺素后，手术被推迟。事件发生两周后计划再次手术。过敏反应发生后 4 天，通过皮肤点刺试验确认罗库溴铵是病因。选择顺式阿曲库铵作为未来手术的替代药物，其反应为阴性。两周后，患者再次手术，无不良事件发生。
如果需要，即使在过敏反应后 4-6 周内，也可以进行早期皮肤测试。
