CROSS-REACTIVITY OF ROCURONIUM WITH OTHER NEUROMUSCULAR BLOCKING-AGENTS

The cross-reactivity of rocuronium with other neuromuscular blocking a gents (NMBAs) was studied in 31 patients known to be allergic to a mus cle relaxant. Tests for diagnosing cross-reactivity were skin tests (p rick tests and intradermal tests: IDTs), detection by RAST assay of Ig Es against the quaternary ammonium group (OAS-RIA: quaternary ammonium sepharose radio-immuno-assay), QAS-RIA inhibition test to detect IgE specificity, and leucocyte histamine release test (LHRT). Skin tests w ere performed with rocuronium, suxamethonium, gallamine, vecuronium, p ancuronium, atracurium. The threshold for cross-reactivity was 10(-1) with all the NMBAs except for atracurium (10(-2)). The inhibition test and LHRT were performed with rocuronium and the NMBA responsible for the shock. Ten volunteers made up the control group for prick tests, O AS-RIA, LHRT. Crossreactivity was found in 30 patients out of 31. Rocu ronium did not cross-react in 10 patients out of 31. They had negative cutaneous tests and negative LHRTs. In one of the five patients aller gic to all the NMBAs available, rocuronium was the only one which did not cross-react. In those 10 patients, rocuronium may be safely used f or subsequent anaesthesia. In terms of allergy, rocuronium appeared to be very close to the other steroidal NMBAs.