Drug Challenge Tests With General Anesthetics: Predictive Value of Skin Tests
| Autor: | A Garrido Sánchez, Blanca Noguerado-Mellado, M L Baeza Ochoa de Ocáriz, M Alonso Mateos, P Tornero Molina, Patricia Rojas-Pérez-Ezquerra, J M Zubeldia Ortuño |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male Drug medicine.medical_specialty Anesthetics General media_common.quotation_subject Immunology Sugammadex Fentanyl Drug Hypersensitivity Remifentanil Young Adult 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests 030202 anesthesiology medicine Humans Immunology and Allergy Rocuronium Perioperative Period Intensive care medicine Propofol Aged Skin Tests media_common Aged 80 and over Protocol (science) business.industry Perioperative Middle Aged Predictive value Analgesics Opioid Atracurium Etiology Female Neuromuscular Blocking Agents business Anesthetics Intravenous medicine.drug |
| Zdroj: | Journal of Investigational Allergology and Clinical Immunology. 30:101-107 |
| ISSN: | 1018-9068 |
| DOI: | 10.18176/jiaci.0402 |
| Popis: | Background The study of perioperative drug reactions remains a major challenge for both diagnosis and therapy. The lack of a standard assessment of allergy to general anesthetics and of data establishing the true value of skin tests for most drugs used in induction and maintenance of anesthesia, as well as the lack of commercially available reagents for in vitro tests, renders the study of these reactions problematic. The aims of this study were to provide a diagnostic protocol for drug challenge testing with general anesthetics, to establish an etiological diagnosis that is as specific as possible, and to determine the predictive value of skin tests. Methods Twenty-nine patients with perioperative drug reactions were included in the study from November 2008 to December 2018. Results We confirmed the high negative predictive value of the tests (96%-100%) in the case of propofol, rocuronium, and fentanyl. To our knowledge, this is the first study to describe drug challenge testing with general anesthetics and, therefore, to establish the true negative predictive value of skin tests, which leads to a definitive diagnosis and safer surgery. Conclusions After assessing risks and benefits and considering the importance of this group of drugs, we conclude that drug challenge testing with general anesthetics is necessary. We propose a protocol for perioperative drug reactions that enables us to make a highly accurate etiological diagnosis with minimum risk for the patient. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|