Periprocedural allergy evaluation is safe and effective to guide subsequent anesthesia administration.

Testing was positive in 30% (22/74).

The most common culprits included antibiotics (10, 45%), local anesthetics (3, 14%), and neuromuscular blocking agents (3, 14%).

Patients with perioperative anaphylaxis were more likely to have positive testing compared to patients with low-grade reactions (63% vs 9%, P < .001).

Fifty-one percent (19/37) of patients tested within ≤6 months of index reaction had positive testing, versus 11% (4/38) tested at >6 months ( P < .001).