Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Division of Immunology and Allergic Diseases, Istanbul, Turkey.
Istanbul University, Istanbul Faculty of Medicine, Department of Anesthesiology and Reanimation, Istanbul, Turkey.
Braz J Anesthesiol. 2022 May-Jun;72(3):350-358. doi: 10.1016/j.bjane.2021.07.005. Epub 2021 Jul 27.
In daily practice, atopic patients and those who have other drug allergies are referred to allergy clinics for evaluation of possible general anesthetic allergy despite the fact that it is not recommended in recent guidelines.
The aim of this prospective study is to determine the negative predictive value of skin tests for common general anesthetic drugs prior to general anesthesia in atopic patients and in patients who had drug allergies by including the data of those who had previously tolerated or reacted to general anesthesia.
A database program was constituted to collect the preoperative skin test data of patients referred to our clinic between 2013 and 2018. Demographic and clinical history, medications implemented during perioperative period, reactions, and results of skin tests performed with anesthetic drugs and latex were evaluated.
Four hundred fifty-nine out of the total 1167 patients referred fulfilled the inclusion criteria for further evaluation. Nearly 75% of the patients were female and mean age was 46.3 ± 14.3 years. History of hypersensitivity reactions (HRs) due to NSAIDs and/or antibiotics, radiocontrast agents, local anesthetics, and food were present in the 53.1%, 4.1%, 1.5%, and 2.0%, respectively. The negative predictive values of skin tests for general anesthetics were in the range of 80-100%. Only 4 patients (0,87%) experienced HRs during operation.
These real-life data reveal high rates of negative predictive value of skin tests with general anesthetic drugs and a low reaction rate in atopic patients and in patients with allergy to other drugs.
在日常实践中，尽管最近的指南不建议这样做，但患有特应性疾病或其他药物过敏的患者会被转介到过敏诊所，以评估是否可能对全身麻醉过敏。
本前瞻性研究旨在确定特应性患者和对其他药物过敏的患者在全身麻醉前进行常见全身麻醉药物皮试的阴性预测值，包括那些先前曾耐受或对全身麻醉有反应的患者的数据。
建立了一个数据库程序，以收集 2013 年至 2018 年间我院就诊的患者的术前皮试数据。评估了人口统计学和临床病史、围手术期使用的药物、反应以及麻醉药物和乳胶进行的皮试结果。
在总共 1167 名转介患者中，有 459 名符合进一步评估的纳入标准。近 75%的患者为女性，平均年龄为 46.3±14.3 岁。由于非甾体抗炎药和/或抗生素、放射性对比剂、局部麻醉药和食物而出现过敏反应史的患者分别占 53.1%、4.1%、1.5%和 2.0%。全身麻醉药物皮试的阴性预测值在 80-100%之间。只有 4 名患者（0.87%）在手术期间出现过敏反应。
这些真实数据显示，特应性患者和对其他药物过敏的患者全身麻醉药物皮试的阴性预测值较高，过敏反应率较低。
