Bonnet M C, du Cailar G, Deschodt J
Département d'Anesthésie-Réanimation, Hôpital Lapeyronie, Montpellier.
Ann Fr Anesth Reanim. 1989;8(2):127-9. doi: 10.1016/s0750-7658(89)80163-7.
A case of a severe anaphylactic reaction in a 30 year old man after 2 ml of 1% lidocaine injected subcutaneously is reported. It consisted in pruritus, urticaria, hypotension (Pasys: 50 mmHg), tachycardia (170 b.min-1) and a coma of short duration. The patient recovered after 1 mg adrenaline injected subcutaneously. The patient's history included a less severe but similar accident, but no manifestations of atopy. The total IgE, two months after the accident, were at the upper limit of normal. A human basophil degranulation test was positive for lidocaine and negative for other amide local anaesthetic agents and preservatives. Similarly, lidocaine was the only molecule giving a positive reaction with intradermal testing. Skin sensitivity to histamine was negative. Although for several authors true allergy to lidocaine is questionable, the case reported here can be added to the other 47 published since 1961.
报告了一例30岁男性在皮下注射2毫升1%利多卡因后发生严重过敏反应的病例。症状包括瘙痒、荨麻疹、低血压（收缩压：50 mmHg）、心动过速（170次/分钟）以及短暂昏迷。皮下注射1毫克肾上腺素后患者康复。患者既往史中有一次不太严重但类似的意外事件，但无特应性表现。事故发生两个月后，总IgE处于正常上限。人嗜碱性粒细胞脱粒试验对利多卡因呈阳性，对其他酰胺类局部麻醉剂和防腐剂呈阴性。同样，利多卡因是皮内试验中唯一产生阳性反应的分子。对组胺的皮肤敏感性为阴性。尽管一些作者认为对利多卡因的真正过敏存在疑问，但此处报告的病例可补充到自1961年以来已发表的其他47例病例中。
