A case of true allergy to amide local anesthetics in a parturient

IgE-mediated hypersensitivity reactions to amide local anesthetics (LAs) are very rare events in anesthesia practice. When such a reaction occurs, anesthesiologists are often left with numerous confounding causes of adverse e after LA administration. Most times, such reactions result from systemic t...

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Main Authors: Vijayanthi Vijayan (Author), Adethen Gunasekaran (Author), Sakthirajan Paneerselvam (Author), Kirthiha Govindaraj (Author)
Format: Book
Published: Wolters Kluwer Medknow Publications, 2024-01-01T00:00:00Z.
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Summary:IgE-mediated hypersensitivity reactions to amide local anesthetics (LAs) are very rare events in anesthesia practice. When such a reaction occurs, anesthesiologists are often left with numerous confounding causes of adverse e after LA administration. Most times, such reactions result from systemic toxicity or non-hypersensitivity reactions. In the event of a true allergy to LA molecules, subsequent administration of the same drug can lead to life-threatening complications. Herewith, we report the successful diagnosis of LA allergy in a parturient who had a history of anaphylaxis following the administration of subarachnoid block with an unknown drug elsewhere. She presented to our institute for her second cesarean section. Skin prick testing was done after a dermatology consultation, which revealed a positive response to lignocaine, bupivacaine, and ropivacaine (preservative-free). She was taken up for elective cesarean section under general anesthesia with complete avoidance of LAs. Postoperative analgesia was instituted with intravenous patient-controlled fentanyl administration. The procedure and recovery were uneventful and both mother and baby were discharged without any issues.
Item Description:2249-4472
10.4103/JOACC.JOACC_10_23