Reactions 1184 - 12 Jan 2008

SBupivacaine/lidocaine

Allergy: case reportA 25-year-old woman developed severe allergy after

receiving bupivacaine [Marcaine] and lidocaine [Xylocaine] forback pain; she was subsequently found to have allergy tobenzoic acid ester and amide local anaesthetics.

The woman received bupivacaine and lidocaine [dosages notstated], plus methylprednisolone acetate, in three infiltrations.After the third infiltration, she developed a vagal reaction [timeto reaction onset not clearly stated]; over the following30 minutes, she developed a pruriginous skin rash and, duringthe next 30 minutes, she developed tongue oedema andsevere bronchospasm.

Epinephrine [adrenalin] was administered, but the womanresponded poorly, and she was intubated and transferred to anICU. After brief extubation the following day, recurrence ofoedema necessitated reintubation for the next few days. Shesubsequently made a complete recovery.

The woman later underwent skin prick tests. She developedrapidly extending maculopapular erythema with lidocaine0.1% and procaine 2% (oedema diameters of 50mm and25mm, respectively) and, on testing 1 year later, 0.0005%bupivacaine elicited a 5mm papule with erythema.Caron AB. Allergy to multiple local anesthetics Allergy and Asthma Proceedings28: 600-601, No. 5, Sep-Oct 2007 - Canada 801079489

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Reactions 12 Jan 2008 No. 11840114-9954/10/1184-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved