Simultaneous anaphylaxis to thiopentone and a neuromuscular blocker: a study of two cases

Two women experienced anaphylactoid reactions after induction of general anaesthesia. Prick tests, intradermal tests (IDT), human basophil degranulation tests (HBDT) and a quaternary ammonium sepharose radioimmunoassay were undertaken several weeks later and repeated together with a leucocyte histamine release (LHR) test after 4 months. Anaphylaxis to suxamethonium was documented by four tests in patient 1 and to pancuronium by four tests in patient 2. Anaphylaxis to thiopentone was shown with IDT, HBDT and LHR in both women. It was concluded that simultaneous anaphylaxis to thiopentone and a neuromuscular blocker had occurred in these patients.