Abstract
A patient suffered profound anaphylactoid reaction during anaesthesia. Intradermal skin testing confirmed the clinical impression that gallamine caused the reaction. The method of testing is discussed. Previous reports of hypersensitivity to the drug are reviewed, and the use of adrenaline, antihistamines and corticosteroids in patient management are considered.
References
1.
Carrie L. E. S.
, and
Buchanan R. L.
(1967 ): “Thiopentone Anaphylaxis ”, Anaesthesia , 22 , p. 290–295.
2.
Clarke R. S. J.
,
Dundee J.W.
, 1975 ): “Adverse Reactions to Intravenous Anaesthetics ”, Brit. J. Anaesth. , 47 , 575 .
3.
Currie T.
,
Whittingham S.
, 1966 ): “Severe Anaphylactic Reaction to Thiopentone ”, Brit. Med. J. , 1 , 1462 .
4.
Currie T.
, (1970 ): “Anaphylactic Manifestations ”, Proc. 3rd Asian Australasian Congress of Anaesthesiology , p. 127 , Butterworth. London.
5.
Dundee J. W.
,
Assem B. S. K.
, 1974 ): “Sensitivity to Intravenous Anaesthetics ”, Brit. Med. J. , 1 , 63 .
6.
Dundee J. W.
(1976 ): “Editorial ”, Brit. J. Anaesth. , 48 , 1 .
7.
Fisher M. McD.
(1975 ): “Severe Histamine Mediated Reactions to Intravenous Drugs used in Anaesthesia ”, Anaesth. Intens. Care , 3 , 180 .
8.
Fisher M. McD.
(1976 ): “Intradermal Testing after Severe Histamine Reactions ”, Anaesth. Intens. Care , 4 , 97 .
9.
Goodman L.
, and
Gilman A.
(1975 ): The Pharmacological basis of Therapeutics , 5th Edition, MacMillan , 509 and 608 .
10.
Hainsworth A. M.
, and
Bingham W.
(1970 ): “An Allergic Circulatory Collapse following the Administration of Muscle Relaxants ”, Anaesthesia , 25 , 105 .
11.
Langton Hewer C.
, and
Atkinson R. S.
(1976 ): Recent Advances in Anaesthesia and Analgesia , 12 , Churchill Livingstone , p. 30 and p. 186 .
12.
Kelly A. J.
, and
Boman A.
(1973 ): “Anaphylaxis under Anaesthesia ”, Anaesth. Intens. Care , 1 , 332 .
13.
Kelly J.
, and
Patterson R.
(1974 ): “Anaphylaxis ”, J. Amer. Med. Ass. , 227 , 1431 .
14.
Lopert H.
(1955 ): “Allergic Reaction to Gallamine Triethiodide ”, Anaesthesia , 10 , 76 .
15.
Mushin W. W.
, 1949 ): “Clinical Use of Gallamine ”, Lancet , 1 , 726 .
16.
Okazaki K.
, 1969 ): “Bronchospasm possibly due to Gallamine ”, Tokushima, J. Exp. Med. , 16 , 9 .
17.
Slavin R.
(1974 ): “Skin Tests in the Diagnosis of Allergies ”, Medical Clinics of North America , 58 , 65 .
18.
Sniper H. A.
(1971 ): “Anaphylaxis Under Anaesthesia ”, Anaesthesia , 26 , 527 .
19.
Strunk H. A.
(1962 ): “Reaction to Thiopental ”, Anesthesiology , 23 , 271 .
20.
Unsworth I. P.
(1972 ): “Thiopentone Anaphylaxis ”, Anaesth. Intens. Care , 1 , 79 .
21.
Walmsley D. A.
(1959 ): “Sensitivity Reactions to Gallamine Triethiodide ”, Lancet , 2 , 237 .
22.
Watt H. K.
(1973 ): “Anaphylactic Shock from Gallamine ”, N.Z. Soc. Anaesth., Newsletter , 20 , 21 .