The prevention of second anaphylactoid reactions to anaesthetic drugs

Fourteen patients who had second reactions to anaesthetic drugs are described. These reactions occurred for various reasons: attributing the initial reaction to the wrong drug, failure to appreciate the possibility of cross sensitivity, and failure to investigate the reaction and explain the reaction fully to the patient. With adequate investigation, communication and avoidance of drugs responsible, use of pretreatment and alternative techniques, the risk of second reactions should be reduced.