Iammatteo M, et al. - Researchers in this study tried to ascertain causative agents for periprocedural hypersensitivity reactions (HSRs). Data portrayed induction agents as the most common causative agents in the patients. This study highlighted a need to establish national guidelines to standardize evaluations and to create a national registry to allow for data sharing, based on the variability in evaluations of periprocedural HSRs across the United States with data published on small sample sizes.

Methods

• They presented a 7-year retrospective medical record review of patients evaluated between December 2009 and January 2017 at a drug allergy center in Bronx, New York for periprocedural HSRs, defined as occurring soon before, during, or soon after a medical procedure or operation with or without general anesthesia.
• They reviewed demographics, description of historical HSRs, results of testing to potential causative medications, and tolerance of subsequent anesthesia.

Results

• A comprehensive evaluation was completed by thirty-four patients.
• An IgE-mediated cause was determined by skin testing in 22 patients (64.7%).
• With midazolam being the most frequently implicated (n = 6 [3 positive skin test results, 3 equivocal skin test results]), the most common causative class of medications was induction agents (n = 9 [36%]).
• They highlighted cefazolin as the most common agent (n = 8 [32%]) followed by ondansetron (n = 3 [12%]).
• Including 3 patients with negative evaluations, sixteen of 22 contacted patients were exposed to subsequent anesthesia.
• Findings unveiled a mild urticarial HSR in one patient.