Atropine is a widely used premedication drug for the prevention of vagal bradycardia and especially in strabismus surgery.
Incidence
Uncommon for anaphylactic shock.
Clinical manifestations
General: anaphylactic shock.
Cutaneous: erythematous rashes (face, neck, chest).
Diagnostic methods
Cutaneous testing.
Intradermal skin-tests at 1/100 are positive in a few cases.
Specific IgE has not been detected.
The Prausnitz-Küstner test is positive in a few cases.
Mechanisms
Positive results of skin tests and Prausnitz-Küstner test suggest an IgE-mediated mechanism.
Management
Avoidance.
Strabismus surgery may be performed with hyoscine or glycopyrronium after skin tests.