Reactions 1199 - 26 Apr 2008

SMepivacaine

Anaphylaxis: case reportA 31-year-old woman experienced anaphylaxis following

administration of mepivacaine [Scandonest] for dental painrelief prior to a procedure.

The woman received two cartridges of 3% mepivacaine;each cartridge contained 66mg in 2.2mL. Within a fewminutes, she developed intense pruritus of her hands and feet,nausea and a need to go to the toilet. After about 10 minutes ofrest, she attempted to walk to the toilet, but vomited and had abrief loss of consciousness. She also had erythema andswelling of her hands. She was taken to hospital.

The woman received parenteral and oral antihistamines. Shehad a serum total IgE level of 178 KU/L.

Intradermal testing revealed positive results for mepivacaineand bupivacaine, and borderline results for lidocaine.Subsequently, she underwent a graded dose challenge with SCinjection of prilocaine, which did not elicit any reactions. Shehas subsequently had further dental procedures usingprilocaine. An in vitro test for IgE specific for mepivacainerevealed a level of 1.4 kUA/L, supporting an IgE-mediatedmechanism.Venemalm L, et al. IgE-mediated reaction to mepivacaine. Journal of Allergy andClinical Immunology 121: 1058-1059, No. 4, Apr 2008 - Sweden 801080539

1

Reactions 26 Apr 2008 No. 11990114-9954/10/1199-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved