González-Delgado P, Antón R, Soriano V, Zapater P, Niveiro E
Sección Alergia, Hospital General de Alicante, Aliccante, Spain.
J Investig Allergol Clin Immunol. 2006;16(5):311-3.
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.
在局部麻醉药的各种不良反应中，IgE介导的反应，尤其是对更常用的酰胺类药物的反应极为罕见。我们报告了一例39岁男性病例，该患者在使用甲哌卡因15分钟后出现瘙痒、全身性荨麻疹伴面部血管性水肿。皮肤试验显示对甲哌卡因、利多卡因和罗哌卡因有强烈阳性反应，但对布比卡因和左旋布比卡因呈阴性反应。此外，布比卡因和左旋布比卡因的双盲安慰剂对照皮下激发试验耐受性良好。我们得出结论，对于罕见的酰胺类局部麻醉药真正过敏反应病例，必须进行广泛的变态反应学研究，以排除交叉反应。
