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KMID : 0854720060260030249
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Korean Journal of Asthma, Allergy and Clinical Immunology
2006 Volume.26 No. 3 p.249 ~ p.253
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A Case of Lidocaine Anaphylaxis
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Lee Sang-Min
Song Woo-Jung
Yang Min-Suk
Lee So-Hee
Kwon Jae-Woo
Kim Tae-Wan
Kim Kyung-Mook
Kim Hee-Kyu
Park Chang-Han
Park Heung-Woo
Chang Yoon-Seok
Kim Sun-Sin
Kim Yoon-Keun
Cho Sang-Heon
Min Kyung-Up
Kim You-Young
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Abstract
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A patient with a history of anaphylaxis after local administration of lidocaine was referred to screen a safe local anesthetic agent for dental procedures. We performed skin prick test with procaine, lidocaine, bupivacaine, mepivacaine, ropivacaine, and levobupivacaine. In accordance with the history of patient, lidocaine showed a positive result in skin prick test (wheal and flare reactions larger than those of histamine, a positive control) while other local anesthetics failed to produce positive reactions. Then, we performed the intradermal test with the above-mentioned anesthetics except lidocaine. As a result, procaine, mepivacaine, and bupiva caine showed positive results. Meanwhile, levobupivacaine and ropivacaine showed negative results in both the skin prick and the intradermal test and no systemic reactions after subcutaneous injection of testing dose (0.5%, 1:1 dilution, 3 mL) of levobupivacaine. Based on these results, we recommended levobupivacaine as a safe agent, and dental procedures were successfully done with it. This case clearly demonstrates that the cross reactivity between local anesthetics is unpredictable and should be confirmed before administration of a different anesthetic.
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KEYWORD
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Lidocaine, Anaphylaxis, Levobupivacaine, Cross-reactivity
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