Reactions 1038 - 12 Feb 2005

★Ropivacaine

First report of delayed hypersensitivity in an elderlypatient: case report

A 74-year-old man experienced a delayed hypersensitivityreaction during epidural block with ropivacaine forpostherpetic neuralgia.

The man started treatment with amitriptyline, alprazolamand loxoprofen, and underwent epidural block with 0.2%ropivacaine 48 or 96 mL/day. Two weeks later, he developed apurpuric skin eruption on his legs and, after 2 days, developedwidespread, blotchy erythema on his arms and trunk;laboratory investigations revealed mild eosinophilia.

The epidural block was stopped, and the man’s othermedications were discontinued, and his skin eruption resolvedwithin 7 days. Two subsequent intradermal tests with 0.2%ropivacaine resulted in the development of erythema within8–72 hours; a skin biopsy revealed lymphocytic andeosinophilic perivascular infiltrates in the dermis. His skineruption did not recur when amitriptyline, alprazolam andloxoprofen were restarted.Ban M, et al. Delayed hypersensitivity due to epidural block with ropivacaine.BMJ 330: 229, No. 7485, 29 Jan 2005 - Japan 800996161

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of allergy associated withropivacaine. The WHO Adverse Drug Reactions databasecontained two reports of allergic reaction associated withropivacaine.

1

Reactions 12 Feb 2005 No. 10380114-9954/10/1038-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved