Perioperative Allergy Clinic

These monthly clinics are for adults (from the age of 16 years) with suspected allergies to drugs that have been administered during anaesthesia, or to other products used during surgery such as antiseptics and equipment that contains latex. This could be to investigate a reaction that has happened in the past to ensure we can safely proceed with planned surgery, or to investigate a recent reaction in order to give safe advice with regards to future anaesthesia and surgery.

Approximately 1 in 10 000 people having an anaesthetic will develop life threatening anaphylaxis. More than 95% of these will survive and make an excellent recovery. If there has been a serious allergic reaction during anaesthesia then you will be referred to the perioperative allergy clinic for specialist allergy testing. It’s essential that you attend this appointment to find out the nature of the reaction, its cause and which drugs can be used safely in the future. Some patients are understandably anxious about having another anaesthetic in the future and should discuss this with their anaesthetist.

The most important thing we will do on the day of your appointment is to take a detailed description of your symptoms, in conjunction with the pattern and timing of events. Based on this history we may suggest some allergy testing. Allergy testing is not always necessary and this will be discussed on the day. If allergy testing is appropriate, we try to do as much as we can on the day of your appointment, but there might be a short wait or further appointments may be necessary.

Types of allergy testing

We offer four different types of allergy testing:

  1. Allergy blood tests

  2. Skin Prick Testing (SPT) – a few gentle scratches on the skin in the presence of your suspected allergens. It is not painful but can get itchy if you react.

    Avoid antihistamines for 5 days before your appointment, as they will affect the test.

    Please bring a list of your current medicines as some other drugs can rarely affect the test.

  3. Intradermal Testing (IDT) – similar to SPT but small injections are given under the skin. This test is only undertaken for the investigation of certain drug allergies. It is usually during the same appointment and will be discussed in further detail if required.

  4. Challenge Testing – this usually requires a separate appointment and is only undertaken in certain circumstances. If it is relevant to you it will be discussed in detail during the clinic visit. It may mean that we refer you to Derriford Hospital, as we undertake a limited range of challenge testing at Torbay.

If the cause of anaphylaxis is found to be an allergy to a specific drug or other product, it is vital that you avoid this drug in the future to prevent further severe reactions. The allergy clinic will give a letter to you and your GP to confirm this and may also advise you on any other similar drugs to avoid. This information will be recorded in your medical notes and on all the relevant electronic systems used at Torbay Hospital so that all other healthcare staff will be aware.

If the allergy is serious, you may be advised to wear a ‘Hazard Warning’ bracelet at all times in case you need emergency treatment. Once the trigger has been identified and recorded, it’s unlikely that another reaction will occur, as long as healthcare staff are aware of it.

It’s important that you always tell all healthcare staff about any confirmed allergies.

If you suffer daily or frequent symptoms of itchy rash and/or swelling and you rely on regular antihistamines or steroid tablets to keep you comfortable then please continue to use them as normal and discuss this with the doctor performing the allergy testing at least 2 weeks in advance of the appointment. You can leave a message for the doctor to contact you by calling the anaesthetic department on 01803 654310.