A primigravida allegedly allergic to local anaesthetics.
Pregnant patients may give a history of allergy to local anaesthetics, but many of these supposed allergies have not been investigated. There is cross-reactivity between the amide local anaesthetics, which are the only group available in the UK for regional analgesia. We report the management of a primigravida who gave a history of allergy to two local anaesthetics, lidocaine and prilocaine. She was admitted to the labour ward at 38 weeks' gestation for challenge testing to the amide local anaesthetic bupivacaine, with full resuscitation and delivery facilities available. The tests proved negative and she was allowed home. She was re-admitted at term in labour and requested epidural analgesia. Epidural bupivacaine with fentanyl was used without incident for labour and forceps delivery. Subsequent allergy testing to lidocaine also proved negative.
Department of Anaesthesia, James Paget Hospital, Great Yarmouth, Norfolk, UK.
S
S
Brown
J R
JR
Jenkins