title: Immediate allergic cross-reactivity to levobupivacaine and ropivacaine.
abstract: Allergic reactions to amide local anaesthetic agents are rare. We report the case of a 74-year-old man who suffered anaphylaxis, presenting with cardiovascular collapse, immediately after receiving regional anaesthesia on two separate occasions, the first involving the use of levobupivacaine and the second using ropivacaine. Skin testing revealed positive reactions to both levobupivacaine and ropivacaine, and negative reactions to articaine and lidocaine. Severe allergic reactions can be caused by the amide local anaesthetic drugs, levobupivacaine and ropivacaine.
authors.affiliation: Department of Anaesthesiology and Intensive Care, Édouard Herriot Hospital, HCL, Lyon, France.
authors.forename: A L
authors.initials: AL
authors.lastname: Calderon
authors.forename: N
authors.initials: N
authors.lastname: Diot
authors.forename: F
authors.initials: F
authors.lastname: Benatir
authors.forename: F
authors.initials: F
authors.lastname: Christin
authors.forename: E
authors.initials: E
authors.lastname: Hautin
authors.forename: C
authors.initials: C
authors.lastname: Truc
authors.forename: B
authors.initials: B
authors.lastname: Allaouchiche
authors.forename: E
authors.initials: E
authors.lastname: Boselli
mesh_terms: D018663:Adrenergic Agents / Q000627:therapeutic use; D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use; D000368:Aged; D000577:Amides / Q000009:adverse effects*; D000707:Anaphylaxis / Q000188:drug therapy / Q000209:etiology*; D000765:Anesthesia, Conduction / Q000009:adverse effects / Q000379:methods; D000779:Anesthetics, Local / Q000009:adverse effects*; D002045:Bupivacaine / Q000009:adverse effects / Q000031:analogs & derivatives; D003429:Cross Reactions; D004342:Drug Hypersensitivity / Q000188:drug therapy / Q000209:etiology*; D004809:Ephedrine / Q000627:therapeutic use; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D009638:Norepinephrine / Q000627:therapeutic use; D000077212:Ropivacaine; D012882:Skin Tests
chemical_list: D018663:Adrenergic Agents; D000316:Adrenergic alpha-Agonists; D000577:Amides; D000779:Anesthetics, Local; D005217:Fat Emulsions, Intravenous; D000077212:Ropivacaine; D000077554:Levobupivacaine; D004809:Ephedrine; D009638:Norepinephrine; D002045:Bupivacaine