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. 2011 Oct;3(4):280-2.
doi: 10.4168/aair.2011.3.4.280. Epub 2011 Sep 1.

Bronchospasm and anaphylactic shock following lidocaine aerosol inhalation in a patient with butane inhalation lung injury

Min-Young Lee  1 , Kyong Ah Park, So-Jeong Yeo, Shin-Hee Kim, Hyeun-Jeong Goong, An-Soo Jang, Choon-Sik Park
Affiliations

Bronchospasm and anaphylactic shock following lidocaine aerosol inhalation in a patient with butane inhalation lung injury

Min-Young Lee et al. Allergy Asthma Immunol Res. 2011 Oct.

Abstract

Allergic reactions to local anesthetics are very rare and represent <1% of all adverse local anesthetics reactions. A 54-year-old man was admitted to the hospital in the winter because of shortness of breath. The patient reportedly had an inhalation lung injury due to butane gas fuel. On the fifth day, he developed an asthmatic attack and anaphylactic shock immediately after lidocaine aerosol administration to prepare for bronchoscopy to confirm an acute inhalational lung injury diagnosis. Cardiopulmonary resuscitation was performed immediately after respiratory arrest, and the patient was admitted to the intensive care unit intubated and on a ventilator. He was extubated safely on the third post-cardiopulmonary resuscitation day. These observations suggest that aerosol lidocaine anesthesia may cause airway narrowing and anaphylactic shock. Practitioners should be aware of this potential complication. We report on this case with a brief review of the literature.

Keywords: Anaphylaxis; immediate hypersensitivity; inhalation; lidocaine.

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Conflict of interest statement

There are no financial or other issues that might lead to conflict of interest.

Figures

Fig. 1
Fig. 1
(A) Chest radiographs revealed bilateral patchy opacities. (B) Computed tomography of the chest revealed multifocal consolidation and ground-glass opacities in all lobes of both lungs as well as right pleural effusion, indicating an acute inhalation lung injury.
Fig. 2
Fig. 2
Changes in oxygen saturation, respiratory rate, and blood pressure. CPR, cardiopulmonary resuscitation.
See this image and copyright information in PMC

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