General Information for Patients and Referrers

Overview of the Royal North Shore Perioperative Allergy Clinic

Experiencing general, sedation or local anaesthesia for a procedure is very safe. However, unpredictable adverse reactions to one of the numerous medications used to provide smooth anaesthesia sometimes occur.

The Royal North Shore Perioperative Allergy Clinic is a dedicated outpatient service for any adult or child who has experienced a suspected drug allergy under anaesthesia care.  A doctor’s referral is required to arrange an appointment.

The clinic provides cross-disciplinary input from anaesthetists and immunologists with expertise in drug allergy investigation and planning for future anaesthesia in affected patients. The Perioperative Allergy team maintains evidence-based practice and actively contributes to the Australian and New Zealand Anaesthetic Allergy Group, which also provides information for people impacted by a suspected drug allergy during surgery.

What happens following a suspected Perioperative Drug Allergy?

A range of allergic-type reactions can unexpectedly occur during a surgical procedure, from mild symptoms, such as transient skin changes, to delayed skin rashes and severe reactions, like anaphylaxis. If a suspected reaction happens during anaesthesia, the anaesthetist will provide immediate treatment. The treating doctor may be a GP or other medical specialist in milder or delayed cases of drug allergy.

In either situation, after recovery, a referral to a specialist clinic is the next step to diagnose the type of reaction and work out what can be done for anaesthesia in the future. A list of specialist clinics and referral documentation can be found on the Australian and New Zealand Anaesthetic Allergy Group website. At Royal North Shore, medical staff triage and review all referrals, after which administrative staff arrange and coordinate appointments with patients. Some blood and skin tests are usually required, which are explained in detail in the clinic information pack and at the consultation.

After the drug allergy investigation process, a culprit drug or substance is usually identified, and a medic alert identification bracelet may be recommended. A detailed report is provided with the findings and suggestions for future anaesthesia to support patients and medical staff plan optimally for future care. Details of the subsequent anaesthetics are requested to be sent to the Perioperative Drug Allergy Clinic to maintain a living document, updated after every anaesthetic. This is especially important for individuals who have experienced an episode of drug-induced anaphylaxis or severe allergy.

Practical Information about the Perioperative Allergy Clinic

The Royal North Shore Perioperative Allergy Clinic investigates reactions to drugs or substances specifically associated with anaesthesia and surgery. For all other allergy referrals, please discuss them with a local GP or phone the Department of Immunology on 9926 4108.

Unless there is an extreme clinical urgency, drug allergy testing is best performed between 4 and 12 weeks after a suspected reaction.

Face-to-face appointments are usually required to facilitate skin testing; however, telehealth is available for certain patients and those unable to attend a face-to-face meeting.

The clinic operates on alternate Wednesday mornings in the outpatient department at Royal North Shore Hospital, and appointments are one to two hours in duration. Blood test forms are usually supplied with appointment information to ensure the tests can be done beforehand and results are available at consultation.  

Previous and established patients of the Royal North Shore Perioperative Allergy Clinic are invited to contact the clinic directly with enquiries, requests for old notes and updates.

Perioperative Allergy CLinic Information and Contact Details