title: Allergic reaction to an amide local anesthetic in segmental epidural analgesia.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, University Central Hospital, Turku, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Erkkola
authors.forename: J
authors.initials: J
authors.lastname: Kanto
authors.forename: J
authors.initials: J
authors.lastname: Mäenpää
authors.forename: P
authors.initials: P
authors.lastname: Kero
authors.forename: M
authors.initials: M
authors.lastname: Hovi-Viander
authors.forename: M
authors.initials: M
authors.lastname: Viander
mesh_terms: 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
chemical_list: D003176:Complement C3; D007073:Immunoglobulin E; D002045:Bupivacaine