Reactions 1162 - 28 Jul 2007

Mepivacaine

Urticaria and pruritus: case reportA 39-year-old man developed pruritus and generalised

urticaria after receiving mepivacaine as a local anaesthetic. Hesubsequently developed cross-reactivity to lidocaine andropivacaine.

The man received mepivacaine [Scandinibsa] [dosage notstated] during extirpation of a naevus; 15 minutes later, hedeveloped pruritus and generalised urticaria.

The urticaria was treated with oral corticosteroids andantihistamines, and resolved within a few hours.

Three months later, the man attended an allergy unit inorder to further investigate the adverse reaction. A prick testwith 1% mepivacaine was positive (5mm). In response to anintradermal test with mepivacaine at a 1:100 dilution, hedeveloped a wheal 12 × 15mm with pseudopodia, and animmediate urticarial reaction that spread along the thorax andforearm. This reaction was treated with antihistamines andsubsided within an hour. In order to assess cross-reactivitywith other amide-type local anaesthetics, prick tests wereperformed with an undiluted solution of each drug, andintradermal tests done at 1:100 dilution. Lidocaine yielded apositive prick test result of 5 × 4mm, and in response to theintradermal skin test, a 20 × 30mm wheal associated with animmediate local urticaria. Ropivacaine yielded a positive pricktest result of 4 × 3mm, and in response to the intradermal skintest, a wheal of 10 × 8mm.Gonzalez-Delgado P, et al. Cross-reactivity among amide-type local anesthetics ina case of allergy to mepivacaine. Journal of Investigational Allergology andClinical Immunology 16: 311-313, No. 5, 2006 - Spain 801078933

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Reactions 28 Jul 2007 No. 11620114-9954/10/1162-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved