Peri‐operative hypersensitivity reactions to neuromuscular blocking drugs in New Zealand 2013–2019: a retrospective observational study
Authors' conclusion
We found a significant difference between the rates of peri-operative hypersensitivity reactions with rocuronium and suxamethonium vs. atracurium.
Study context
- Population
- Adults in New Zealand exposed to NMBAs peri-operatively
- Exposure
- Suxamethonium vs rocuronium vs atracurium
- Outcome
- Incidence and relative risk of peri-operative hypersensitivity reaction to individual NMBAs
Methodological detailsobservational
- Observational
Main finding
As reported in the abstract
Risk of peri-operative hypersensitivity reaction
Suxamethonium
1:1500
95% CI 1000–2500
Rocuronium
1:3300
95% CI 2100–5300
Atracurium
1:15,000
95% CI 6800–40,000
Observational data: associations, not effects.
Further findings
Sex
- Female patients up to eight times more likely to experience a peri-operative hypersensitivity reaction than males
- 8
Cross-sensitivity on skin testing
- After reaction to rocuronium, suxamethonium or vecuronium, atracurium is the lowest risk alternative
- After reaction to atracurium, rocuronium and suxamethonium are low risk alternatives
Original publication
Peri‐operative hypersensitivity reactions to neuromuscular blocking drugs in New Zealand 2013–2019: a retrospective observational study. Anaesthesia. Published 10 November 2025. doi:10.
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