Anaphylactoid reactions to neuromuscular blocking agents: a commonly undiagnosed condition?

A group of 28 patients with extreme, life-threatening sensitivity to suxamethonium was identified and 15 were studied in detail by skin-testing. The female/male ratio was 8/1. Sensitivity may be present without previous exposure to suxamethonium; in 3 patients reactions occurred during the first exposure to anaesthesia. Most patients showed one or more cross-sensitivities to alcuronium, tubocurarine, and gallamine. Signs of circulatory collapse were the sole presenting feature in 50% of the patients. Histamine release induced by the drug in vitro was demonstrated in some instances.