title: Anaphylaxis to the chlorhexidine component of Instillagel: a case series.
abstract: Anaphylaxis to chlorhexidine is rare. We report three cases of anaphylaxis attributed to the chlorhexidine component of Instillagel, presenting after urological surgery, while the patients were in the recovery room. In these cases, the cause of the collapse was not immediately obvious as the presentation was delayed. Anaesthetists should be aware that urethral lubricants may contain chlorhexidine that can trigger anaphylaxis in susceptible individuals. Anaphylaxis should be considered a possible diagnosis when a patient collapses in the recovery room. Investigation of suspected anaphylactic reactions related to anaesthesia is important to try and identify a likely trigger for a reaction and to help prevent further exposure and potential harm.
authors.affiliation: Department of Anaesthesia, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK.
authors.forename: A W
authors.initials: AW
authors.lastname: Parkes
authors.forename: N
authors.initials: N
authors.lastname: Harper
authors.forename: A
authors.initials: A
authors.lastname: Herwadkar
authors.forename: R
authors.initials: R
authors.lastname: Pumphrey
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000139:chemically induced*; D000891:Anti-Infective Agents, Local / Q000009:adverse effects; D002710:Chlorhexidine / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000209:etiology*; D005260:Female; D006801:Humans; D054327:Lubricants / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000139:chemically induced*; D014546:Urinary Catheterization / Q000379:methods; D013520:Urologic Surgical Procedures
chemical_list: D000891:Anti-Infective Agents, Local; D054327:Lubricants; D002710:Chlorhexidine