Early skin testing is effective for diagnosis of hypersensitivity reactions occurring during anesthesia
Lafuente A (1), Javaloyes G, Berroa F, Goikoetxea MJ, Moncada R, Núñez-Córdoba JM, Cabrera-Freitag P, D'Amelio C, Sanz ML, Gastaminza G.
(1) Department of Anesthesia, Medical School, Clínica Universidad de Navarra, Pamplona, Spain
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.
CITATION Allergy. 2013 Jun;68(6):820-2. doi: 10.1111/all.12154. Epub 2013 May 6.