General anaesthesia for the patient with a history of anaesthesia-related anaphylaxis is challenging. Precautions against anaphylaxis and the use of skin test negative drugs can reduce but not eliminate the risk. In the majority of such cases, subsequent anaesthesia is uneventful. However, the absence of a clearly identified triggering agent increases the difficulties facing the anaesthetist. We present a case of anaphylaxis to cisatracurium following a negative skin test.
FisherM.M., BaldoB.A.The incidence and clinical features of anaphylactic reactions during anaesthesia in Australia.Ann Fr Anesth Reanim1993; 12: 97–104.
2.
CurrieM., WebbR.K., WilliamsonJ.A., RussellW.J., MackayP.Clinical Anaphylaxis: An analysis of 2000 incident reports.Anaesth Intensive Care1993; 21: 621–625.
3.
GalletlyD.C., TreurenB.C.Anaphylactoid reactions during anaesthesia. Seven years’ experience of intradermal testing.Anaesthesia1985; 40: 329–333.
4.
RoseM., FisherM.Rocuronium: high risk for anaphylaxis?Br J Anaesth2001; 86: 678–682.
5.
FisherM.M., MerefieldD., BaldoB.Failure to prevent an anaphylactic reaction to a second neuromuscular blocking drug during anaesthesia.Br J Anaesth1999; 82: 770–773.
6.
BouazizH., LaxenaireM-C. Anaesthesia for the allergic patient.Curr Opin Anaesthesiol1998; 11: 339–344.
MeretojaO.A., TaivainenT., WirtavuoriK.Cisatracurium during halothane and balanced anaesthesia in children.Paediatr Anaesth1996; 6: 373–378.
9.
WastilaW., MaehrR., TurnerG., HillD., PhilM., SavareseJ.Comparative pharmacology of cisatracurium (51W89), atracurium, and five isomers in cats.Anesthesiology1996; 85: 169–177.
10.
MertesP.M., LaxenaireM.C., AllaF.Anaphylactic and anaphylactoid reactions occurring during anesthesia in France in 1999–2000.Anesthesiology2003; 99: 536–545.
11.
KrombachJ., HunzelmanN., KosterF., BischoffA., Hoffmann-MenzelH., BuzelloW.Anaphylactoid reactions after cisatra-curium administration in six patients.Anesth Analg2001; 93: 1257–1259.
12.
HunzelmanN., KopnerR., HaniN., Scharffetter-KochanekK.Immediate-type reactions to cisatracurium.Allergy1999; 54: 1227–1228.
13.
BriassoulisG., HatzisT., MammiP., AlikatoraA.Persistent anaphylactic reaction after induction with thiopentone and cisatracurium.Paediatr Anaesth2000; 10: 429–434.
14.
ClendenenS.R., HarperJ.V., WharenR.E., GuarderasJ.C.Anaphylactic reaction after cisatracurium.Anesthesiology1997; 87: 690–692.
15.
TohK.W., DeacockS.J., FawcettW.J.Severe anaphylactic reaction to cisatracurium.Anesth Analg1999; 88: 462–464.
16.
FisherM.M.Cisatracurium and atracurium as antigens.Anaesth Intensive Care1999; 27: 369–370.
17.
LegrosC.B., OrliaguetG.A., MayerM., LabbezF., CarliP.A.Severe anaphylactic reaction to cisatracurium in a child.Anesth Analg2001; 92: 648–649.
18.
SoetensF., SmoldersF.Different intradermal skin testing response to atracurium and cisatracurium after an anaphylactoid reaction during general anaesthesia.Anesth Intensive Care2002; 30: 699.
19.
WrightP.M., McCarthyG., SzenohradszkyJ., SharmaM.L., CaldwellJ.E.Influence of chronic phenytoin administration on the pharmacokinetics and pharmacodynamics of vecuronium.Anesthesiology2004; 100: 626–633.
20.
LorenzW., DudaD., DickW.. Incidence and clinical importance of perioperative histamine release: randomised study of volume loading and antihistamines after induction of anaesthesia.Lancet1994; 343: 933–940.
21.
ThongB.Y.H., ChanY.Anaphylaxis during surgical and inter-ventional procedures.Ann Allergy Asthma Immunol2004; 92: 619–628.
22.
DahlJ.B.Antihistamine prophylaxis and general anaesthesia.Lancet1994; 343: 929–930.
23.
HepnerD.L., CastellsM.C.Anaphylaxis during the perioperative period.Anesth Analg2003; 97: 1381–1395.
