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[Anaphylaxis caused by lidocaine].

M C Bonnet1, G du Cailar, J Deschodt

  • 1Département d'Anesthésie-Réanimation, Hôpital Lapeyronie, Montpellier.

Annales Francaises D'Anesthesie Et De Reanimation
|January 1, 1989
PubMed
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A severe anaphylactic reaction occurred in a 30-year-old man after a lidocaine injection. Diagnostic tests confirmed lidocaine as the allergen, supporting its role in rare hypersensitivity reactions.

Area of Science:

  • Anesthesiology
  • Allergy and Immunology

Background:

  • Lidocaine is a widely used local anesthetic.
  • Hypersensitivity reactions to local anesthetics, though rare, can be severe.

Observation:

  • A 30-year-old male experienced severe anaphylaxis, including hypotension and coma, after subcutaneous lidocaine injection.
  • The patient had a prior similar, less severe episode but no history of atopy.
  • Skin sensitivity tests were positive for lidocaine but negative for other local anesthetics and preservatives.

Findings:

  • Human basophil degranulation test confirmed specific IgE-mediated hypersensitivity to lidocaine.
  • Intradermal testing also indicated a specific allergy to lidocaine.
  • Total IgE levels were within the normal range, despite the severe reaction.

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Implications:

  • This case adds to the evidence supporting true lidocaine allergy.
  • Highlights the importance of considering lidocaine hypersensitivity in unexplained anaphylactic reactions.
  • Suggests specific diagnostic testing for accurate identification of local anesthetic allergy.