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Case Report |
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Cross-Reactivity Among Amide-Type
Local Anesthetics in a Case of Allergy to Mepivacaine |
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P González-Delgado,1 R Antón,2 V
Soriano, 1 P Zapater, 3 E Niveiro
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1 Sección Alergia, Hospital General de
Alicante, Alicante, Spain
2 Servicio de Anestesia, Hospital General de Elche,
Alicante, Spain
3 Servicio de Farmacología, Hospital General de
Alicante, Alicante, Spain |
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J Investig Allergol Clin Immunol
2006; Vol. 16(5): 311-313 |
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Abstract |
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Among the various
adverse reactions to
local anesthetics,
IgE-mediated
reactions,
particularly to the
more commonly used
amide group, are
extremely rare. We
report the case of a
39-year-old man who
suffered itching and
generalized
urticaria with
facial angioedema 15
minutes after
administration of
mepivacaine. Skin
tests revealed a
strong positive
reaction to
mepivacaine,
lidocaine, and
ropivacaine, but
negative reactions
to bupivacaine and
levobupivacaine.
Furthermore, double-blind
placebo-controlled
subcutaneous
challenge with
bupivacaine and
levobupivacaine was
well tolerated.
We conclude that an
extensive
allergologic study
must be carried out
in rare cases of
true allergic
reaction to amide-type
local anesthetics in
order to rule out
cross reactivity.
Key words:
Local anesthetics.
Amide group. Allergy.
Mepivacaine.
Lidocaine.
Ropivacaine.
Bupivacaine.Levobupivacaine |
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