title: Anaphylaxis secondary to levobupivacaine.
abstract: We describe the case of a 25-year-old woman presented for elective lumbar decompression and microdiscectomy who, towards the end of her surgery, developed clinical signs of anaphylaxis. Skin testing later confirmed sensitisation to levobupivacaine and possibly MediShield, an anti-adhesion gel used following microdiscectomy. This case is the first confirmed case report of anaphylaxis in response to levobupivacaine. It also highlights the possibility that multiple agents may simultaneously trigger a life-threatening reaction. Anaesthetists should remain alert to the use of potentially allergenic agents employed by surgeons.
authors.affiliation: Royal Marsden Hospital, London, UK. anish147@gmail.com
authors.forename: A
authors.initials: A
authors.lastname: Gupta
authors.forename: M
authors.initials: M
authors.lastname: Fennelly
authors.forename: V
authors.initials: V
authors.lastname: Ramesh
authors.forename: K
authors.initials: K
authors.lastname: Agyare
mesh_terms: D000328:Adult; D000707:Anaphylaxis / Q000188:drug therapy / Q000209:etiology* / Q000628:therapy*; D000768:Anesthesia, General; D000779:Anesthetics, Local / Q000009:adverse effects*; D002045:Bupivacaine / Q000009:adverse effects / Q000031:analogs & derivatives; D019299:Decompression, Surgical; D017586:Diskectomy; D004342:Drug Hypersensitivity / Q000188:drug therapy / Q000628:therapy*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal; D000077554:Levobupivacaine; D012882:Skin Tests; D053802:Tryptases / Q000097:blood
chemical_list: D000779:Anesthetics, Local; D000077554:Levobupivacaine; D053802:Tryptases; D002045:Bupivacaine