An anaphylaxis during general anesthesia does not occur very frequent, but associates with signifi cant mortality. The causes of anaphylaxis can be complex because of the large number of medications administered in the same time. All patients with history of perioperative anaphylaxis should have an extensively appropriate evaluation. The aller-gist is responsible for identifying the cause and other agents likely to be safe for future use. Here, we reported a patient with severe allergic reactions twice due to neuromuscu-lar blocking agents; atracurium and cisatracurium, which were confi rmed by allergy skin test. Furthermore, we reviewed the literatures concerning the diagnosis and prevention of patients with anaphylaxis in the perioperative setting.
