Thiopentone anaphylaxis

Brown, T.P. (1975) Thiopentone anaphylaxis case report. Anaesth. Intens. Care, 3, 257. 

Moneret-Vautrin DA, Widmer S, Gueant JL, Kamel L, Laxenaire MC, Mouton C, Gerard H. Simultaneous anaphylaxis to thiopentone and a neuromuscular blocker a study of two cases. Br J Anaesth 1990 64(6) 743-5. 

Unlike NMBDs, previous exposure to thiopentone is a predisposing factor in producing anaphylaxis. Anaphylaxis on first exposure is unusual at least six exposures are usually required and up to 37 uneventful exposures have been reported prior to the first reaction. Patients who react to thiopentone are older than reactors to NMBDs (43 vs. 36 years), women predominate with a female to male ratio of three to one, and the incidences of a history of allergy (42 %), atopy (36 %), and asthma (22 %) are similar to NMBD reactors. Also, unlike NMBDs, hypersensitivity reactions ranging from rashes to urticaria and severe exfoliative dermatitis have been seen with thiopentone. 

Challenge tests with thiopentone have been used to confirm the diagnosis of anaphylaxis to the drug. Results obtained in challenge tests on two patients give some indication of the responses that might be expected. After building up the... 

Baldo BA, Fisher MM. Diagnosis of IgE-dependent anaphylaxis to neuromuscular blocking drugs, thiopentone and opioids. Ann Fr Anesth Reanim. 1993 12 173-81. 

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