Delayed hypersensitivity reaction of the knee after injection of arthroscopy portals with bupivacaine (marcaine)
The number of arthroscopic procedures performed annually for the management of intraarticular injuries has grown at an exponential rate. Whether done with the patient under general anesthesia or local anesthesia supplemented with intravenous sedation, it is common practice to postoperatively inject each portal as well as the joint with a local anesthetic to provide pain relief in the transition to the recovery room and discharge after outpatient surgery. To our knowledge, no previous reports of localized urticaria and delayed hypersensitivity reaction have been reported in the postarthroscopy setting. We are reporting a case of delayed hypersensitivity reaction and urticaria of the knee that presented after bupivacaine (Marcaine) injection of arthroscopic portals after routine meniscectomy.
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Department of Orthopaedic Surgery, Jefferson Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania.
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D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D001182:Arthroscopy; D002045:Bupivacaine / Q000009:adverse effects* / Q000627:therapeutic use; D003875:Drug Eruptions / Q000209:etiology*; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000139:chemically induced*; D007270:Injections, Intra-Articular; D008297:Male; D008592:Menisci, Tibial / Q000601:surgery*; D010149:Postoperative Pain / Q000517:prevention & control*; D012421:Rupture; D000070600:Tibial Meniscus Injuries; D014581:Urticaria / Q000139:chemically induced*
D002045:Bupivacaine