The purpose of this review is to provide an update on how best to manage the analysis of suspected perioperative hypersensitivity reactions based on recent literature and critical publications.

In the past two years, several significant initiatives have been taken in perioperative hypersensitivity. The 6th national audit project in the United Kingdom has provided new knowledge through a series of studies, including a prospective nationwide survey. The European Academy of Allergy and Clinical Immunology has commissioned a position paper with updated recommendations for investigations. Lastly, a large international working group comprising experts in anesthesiology, allergology, and immunology, the International Suspected Perioperative Allergic Reactions group, has published a series of articles providing updates and insights into several different critical areas of perioperative hypersensitivity.

The investigation of perioperative hypersensitivity reactions is highly complex. It aims to identify the correct culprit to ensure future avoidance and disprove allergy to other suspected culprits, making them available for subsequent anesthesia. To achieve this, close collaboration between anesthesiologists and allergists is called upon to ensure the best possible outcome for the patient. Further studies are required for the investigation of perioperative hypersensitivity reactions.