Allergy skin testing with nonirritating concentrations of anesthetic agents

Immediate hypersensitivity reactions to anesthetic agents are rare, but with a worrying morbidity and mortality rate. Allergy evaluation is mandatory when hypersensitivity reactions to anesthetic agents are suspected. Skin prick tests and intradermal tests are important tools due to their clinical utility in establishing the diagnosis of IgE-mediated hypersensitivity and evaluation of cross-reactivity. This article presents, for informational purposes only, the nonirritating concentrations of general anesthetics and adjuvant agents, neuromuscular blocking agents and agents used in local and regional anesthesia, used in clinical practice for allergy skin testing according to international guidelines. The delayed hypersensitivity adverse reactions can be assessed by patch testing. Concentrations used for such skin testing with topical anesthetic agents from the European baseline series, international comprehensive baseline series and medicament series, are also presented.