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Drug Challenge Tests With General Anesthetics: Predictive Value of Skin Tests.
Tornero Molina, P; Rojas-Perez-Ezquerra, P; Noguerado-Mellado, B; Baeza Ochoa de Ocáriz, M L; Garrido Sánchez, A; Alonso Mateos, M; Zubeldia Ortuño, J M.
Afiliação
  • Tornero Molina P; Allergy Department, University Hospital Gregorio Marañón and Gregorio Marañón Health Research Institute, Madrid, Spain.
  • Rojas-Perez-Ezquerra P; Allergy Department, University Hospital Gregorio Marañón and Gregorio Marañón Health Research Institute, Madrid, Spain.
  • Noguerado-Mellado B; Allergy Department, University Hospital Gregorio Marañón and Gregorio Marañón Health Research Institute, Madrid, Spain.
  • Baeza Ochoa de Ocáriz ML; Allergy Department, University Hospital Gregorio Marañón and Gregorio Marañón Health Research Institute, Madrid, Spain.
  • Garrido Sánchez A; Anesthesiology Department, University Hospital Gregorio Marañón and Gregorio Marañón Health Research Institute, Madrid, Spain.
  • Alonso Mateos M; Anesthesiology Department, University Hospital Gregorio Marañón and Gregorio Marañón Health Research Institute, Madrid, Spain.
  • Zubeldia Ortuño JM; Allergy Department, University Hospital Gregorio Marañón and Gregorio Marañón Health Research Institute, Madrid, Spain.
J Investig Allergol Clin Immunol ; 30(2): 101-107, 2020 Apr 24.
Article em En | MEDLINE | ID: mdl-31058590
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.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Anestésicos Gerais / Hipersensibilidade a Drogas Tipo de estudo: Guideline / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Anestésicos Gerais / Hipersensibilidade a Drogas Tipo de estudo: Guideline / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2020 Tipo de documento: Article