title: An unexpected cause of an acute hypersensitivity reaction during recovery from anaesthesia.
abstract: Acute hypersensitivity reactions to chlorhexidine in the operating room are probably more likely to occur during the early phases of anaesthesia because chlorhexidine is often used for cleaning the surgical field or during placement of indwelling catheters. We report a case of an acute hypersensitivity reaction that occurred in the post anaesthetic care unit. Subsequent skin testing suggested sensitivity to chlorhexidine, which had been applied over the vaginal mucosa at the end of surgery. Relevant issues in the investigation of acute hypersensitivity reactions in the post anaesthetic period are discussed.
authors.affiliation: Department of Anaesthesia, St George Hospital, Kogarah, New South Wales.
authors.forename: C L
authors.initials: CL
authors.lastname: Thong
authors.forename: M
authors.initials: M
authors.lastname: Lambros
authors.forename: M G
authors.initials: MG
authors.lastname: Stewart
authors.forename: P C A
authors.initials: PC
authors.lastname: Kam
mesh_terms: D000208:Acute Disease; D000368:Aged; D000707:Anaphylaxis / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D000762:Anesthesia Recovery Period; D000772:Anesthesia, Local / Q000009:adverse effects*; D018926:Anti-Allergic Agents / Q000008:administration & dosage; D000891:Anti-Infective Agents, Local / Q000009:adverse effects*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001794:Blood Pressure / Q000187:drug effects; D001993:Bronchodilator Agents / Q000008:administration & dosage; D002710:Chlorhexidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D003490:Cyanosis / Q000209:etiology; D004342:Drug Hypersensitivity / Q000150:complications* / Q000188:drug therapy; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D005780:Gelatin / Q000008:administration & dosage; D006801:Humans; D006854:Hydrocortisone / Q000008:administration & dosage; D011183:Postoperative Complications / Q000139:chemically induced / Q000188:drug therapy; D011398:Promethazine / Q000008:administration & dosage; D012697:Serine Endopeptidases / Q000097:blood; D013386:Succinates / Q000008:administration & dosage; D053802:Tryptases; D014621:Vagina / Q000601:surgery
chemical_list: D018926:Anti-Allergic Agents; D000891:Anti-Infective Agents, Local; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D013386:Succinates; C060085:succinylated gelatin; D005780:Gelatin; D012697:Serine Endopeptidases; D053802:Tryptases; D011398:Promethazine; C010882:chlorhexidine gluconate; D002710:Chlorhexidine; D006854:Hydrocortisone; D004837:Epinephrine