Roper A J, Farragher A, Homer J J, Helbert M
Department of Otolaryngology-Head and Neck Surgery, Immunology, Manchester Royal Infirmary, UK.
J Laryngol Otol. 2007 Aug;121(8):e11. doi: 10.1017/S002221510700878X. Epub 2007 May 31.
We report a case of angioedema caused by angiotensin-converting enzyme inhibitor and topical lignocaine spray, administered during nasendoscopy. Angioedema induced by angiotensin-converting enzyme inhibitors is a rare but well known entity. Allergy to topical lignocaine has been acknowledged as a rare phenomenon when used for dental surgery and for skin anaesthesia, but it has not previously been reported after topical administration prior to nasendoscopy. In the reported case, our patient was unfortunate enough to be allergic to both lisinopril and lignocaine. The result was life-threatening airway obstruction, and the continued use of lignocaine spray sustained the laryngeal oedema. We advise that patients are asked about any and every allergy--specifically, any previous problems with dental procedures--before administration of local anaesthetic spray to the upper aerodigestive tract.
我们报告一例血管性水肿病例，其由血管紧张素转换酶抑制剂及鼻内镜检查期间使用的局部利多卡因喷雾剂引起。血管紧张素转换酶抑制剂诱发的血管性水肿虽罕见但广为人知。局部利多卡因过敏在用于牙科手术及皮肤麻醉时被认为是罕见现象，但此前在鼻内镜检查前局部给药后尚未见报道。在所报告的病例中，我们的患者不幸对赖诺普利和利多卡因均过敏。结果导致危及生命的气道梗阻，持续使用利多卡因喷雾剂使喉水肿持续存在。我们建议，在对上呼吸道给予局部麻醉喷雾剂之前，询问患者的所有过敏情况，特别是既往牙科手术有无任何问题。
