The true incidence of anaphylactic reactions and their associated morbidity and mortality remain poorly defined. This is due to uncertainties in reporting accuracy and exhaustivity. A 23 years old male developed severe anaphylaxis under general anesthesia with cardiovascular collapse, bronchospasm and angio-edema. He was promptly managed with intravenous Adrenaline, Hydrocortisone, colloid solutions and Promethazine. The temporal relation suggested Atracurium to be the cause. However, skin prick test, performed 8 weeks later, showed a very strong (+++) positive test for Atracurium and mild sensitivity (+) with Suxamethonium. No sensitivity to Nalbuphine, Thiopentone or Pancuronium was noted. The relevant information was endorsed in patient's medical record sheet for his future exposure.
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