Allergic reaction to an amide local anesthetic in segmental epidural analgesia.
A very serious case of anaphylactoid reaction to bupivacaine occurred during epidural analgesia. A rise in complement 3 activation products and a decrease in immunoglobulin E were observed, while bupivacaine toxicity was ruled out by normal serum concentration. Severe maternal hypotension, and a sudden decrease in the fetal heart rate were detected clinically. By a cesarean section, a baby girl was delivered, who at the age of 1 year appears normal.
Erkkola
R
R
Department of Obstetrics and Gynecology, University Central Hospital, Turku, Finland.
Kanto
J
J
Mäenpää
J
J
Kero
P
P
Hovi-Viander
M
M
Viander
M
M
D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced*; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000773:Anesthesia, Obstetrical / Q000009:adverse effects*; D002045:Bupivacaine / Q000009:adverse effects*; D003176:Complement C3 / Q000032:analysis; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000032:analysis; D007231:Infant, Newborn; D011247:Pregnancy
D003176:Complement C3; D007073:Immunoglobulin E; D002045:Bupivacaine