Skin tests propofol

In Asia allergies to soy are well known and an association of soybean allergy with propofol-induced anaphylaxis has been suggested. In a recent convincing case, anaphylaxis with severe oropharyngeal edema and bronchospasm occurred in a 74-year-old woman with a history of soy allergy a few minutes after receiving propofol. Skin prick tests revealed positive reactions to propofol and 20 % Intralipid which, like the propofol formulation, contains soybean oil. It was concluded that the anaphylactic reaction was caused by the soybean oil present in the administered propofol. 

Anaphylactic reactions occasionally occur to the hypnotics thiopentone and propofol. Both are diagnosed by skin testing and the former also by a specific IgE test. 

Fentanyl (no details) Breathing difficulties, wheezing, frothy secretions LTT SPT Positive for fentanyl and proposol Positive for meperidine Anaphylaxis to fentanyl and propofol Diagnosis not firmly established. Could be anaphylactoid. No positive skin test for fentanyl. Relevance of LTT and meperidine SPT Cone, of meperidine SPT ... 

A 35-year-old woman, scheduled for an emergency cesarean section, was anesthetized with propofol 2 mg/kg and rocuronium 0.9 mg/kg and maintained with sevoflurane. About 15 minutes before the end of the operation she became tachycardic, difficult to ventilate, and hypoxic despite 70% oxygen. After a second dose of propofol for reintubation, she again became hypotensive and profoundly hypoxic and required inotropic support. Pulmonary edema was diagnosed. Afterwards, a skin test showed a strong weal and flare reaction to propofol. 

A 44-year-old woman was given ondansetron, vecuronium, and propofol at induction for elective surgery and immediately became hypotensive (60/30 mmHg) [35 ]. There were no accompanying skin or systemic symptoms, and the episode resolved completely after treatment with intravenous adrenaline, promethazine, hydrocortisone, and fluids. Subsequent skin prick tests with ondansetron, vecuronium, and propofol were negative, but intradermal testing with ondansetron 0.02 mg/ml produced a positive wheal reaction. 

---