Anaphylactic and anaphylactoid reactions in the perioperative period

In the perioperative period, there are numerous anesthetic, therapeutic, and diagnostic agents that can cause a generalized reaction. Allergy skin tests and in vitro tests for IgE antibodies to a variety of substances including thiopental, neuromuscular blocking agents, and substances not directly related to the anesthesia, such as latex and antibiotic, have provided evidence that many of these reactions are allergic and thus truly anaphylactic. Prevention of a recurrent reaction depends on the identification and subsequent avoidance of the offending substance or, alternatively, the avoidance of all suspected substances.