Alternative topical anesthesia for bronchoscopy in a case of severe lidocaine allergy

Hensley, M.; Singer, Benjamin H.

doi:10.1016/j.rmcr.2017.12.010

Cited by 4 publications

(3 citation statements)

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“…Mechanistically, the allergy was often thought to be the result of sensitivity to methylparaben, the preservative within the solution [24][25][26][27]. In addition, our sensitivity result showed substantial increase of risk after expanding the sample.…”

Section: Sensitivity Analysismentioning

confidence: 77%

Concomitant Medication Use with Xiyanping Injection and the Risk of Suspected Allergic Reactions: A Nested Case-Control Study Based on China’s National Medical Insurance Database

Tong¹,

Zhu²,

Wang³

et al. 2021

Preprint

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Introduction Xiyanping injection (XYP), a type of Traditional Chinese Medicine, is often applied in combination with other medications in treating bronchitis, tonsillitis, and bacillary dysentery in China, which is evidently associative with allergic reactions. In recent years, XYP’s adverse drug reactions (ADRs), represented by allergic reactions, have emerged throughout the country.Objective This study aims to investigate the association between the concomitant use of XYP and 25 most frequently co-applied medications with suspected allergic reactions for China’s patients receiving XYP.Methods A nested case-control study was conducted using the sampling data from 2015 China’s Urban Employees Basic Medical Insurance and Urban Residents Basic Medical Insurance database. Four anti-allergic marker drugs were used to evaluate suspected allergic reactions. Univariate analyses and multivariable conditional logistic regression were conducted, and results were reported as odds ratios (ORs) with 95% confidence interval (CI). Sensitivity analyses were performed on the expanded sample by including those prescribed with anti-allergic marker drugs on the same day as XYP and then stopped XYP on the next day.Results Out of 57,612 participants with XYP prescription, we got 949 matched case-control pairs. Multivariable conditional logistic regression revealed that seven concomitant medications including gentamicin (OR = 4.3; 95% CI [2.5, 7.3]), cefoperazone-sulbactam (OR = 4.3; 95% CI [1.4, 13.0]), lidocaine (OR = 2.8; 95% CI [1.8, 4.2]), aminophylline (OR = 1.7; 95% CI [1.1, 2.9]), ribavirin (OR = 1.5; 95% CI [1.1, 2.1)), potassium chloride (OR = 1.4; 95% CI [1.1, 1.9]), and vitamin C (OR = 1.3; 95% CI [1.0, 1.7]) were associated with increased risk, while cefathiamidine (OR = 0.3; 95% CI [0.2, 0.5]) was associated with reduced risk. Sensitivity analysis on 2,438 matched pairs revealed similar findings. Conclusion Increased risks for suspected allergic reactions were found for the concomitant use of XYP with seven medications. Our data suggest that gentamicin, cefoperazone-sulbactam, lidocaine and ribavirin should be applied with precautions for patients receiving XYP, and further studies on drug interactions and allergy mechanisms are warranted.

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Section: Sensitivity Analysismentioning

confidence: 77%

Concomitant Medication Use with Xiyanping Injection and the Risk of Suspected Allergic Reactions: A Nested Case-Control Study Based on China’s National Medical Insurance Database

Tong¹,

Zhu²,

Wang³

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Notably, allergy caused by lidocaine in clinical uses has rarely been reported, but when it occurred, it was usually severe or even life-threatening ( Bhole et al, 2012 ; Batinac et al, 2013 ; Jenerowicz et al, 2014 ; Kim et al, 2019 ). Mechanistically, the allergy was often thought to be the result of sensitivity to methylparaben, the preservative within the solution ( Latronica et al, 1969 ; Speca et al, 2010 ; Grzanka et al, 2016 ; Hensley and Singer, 2018 ). In addition, our sensitivity results showed a substantial increase in risk after expanding the sample.…”

Section: Discussionmentioning

confidence: 99%

Concomitant Medication Use With Xiyanping Injection and the Risk of Suspected Allergic Reactions: A Nested Case–Control Study Based on China’s National Medical Insurance Database

et al. 2022

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Introduction: Xiyanping injection (XYP), a type of Traditional Chinese Medicine, is widely used and often applied in combination with other medications in treating bronchitis, tonsillitis, and bacillary dysentery in China. In recent years, an elevated risk of allergic reactions has been observed following XYP, but whether concomitant medication use contributes to this risk is still unknown.Objective: This study aims to investigate the association between the concomitant use of XYP and the 25 most frequently co-applied medications with suspected allergic reactions for China’s patients receiving XYP.Methods: A nested case–control study was conducted using the sampling data from 2015 China’s Urban Employees Basic Medical Insurance and Urban Residents Basic Medical Insurance database. Four anti-allergic marker drugs were used to evaluate suspected allergic reactions. Univariate analyses and multivariable conditional logistic regression were conducted, and results were reported as odds ratios (ORs) with a 95% confidence interval (CI). Sensitivity analyses were performed on the expanded sample by including those prescribed with anti-allergic marker drugs on the same day as XYP and then stopped XYP on the next day.Results: Out of 57,612 participants with XYP prescription, we obtained 949 matched case–control pairs. Multivariable conditional logistic regression revealed that seven concomitant medications including gentamicin [OR = 4.29; 95% CI (2.52, 7.30)], cefoperazone-sulbactam [OR = 4.26; 95% CI (1.40, 13.01)], lidocaine [OR = 2.76; 95% CI (1.79, 4.25)], aminophylline [OR = 1.73; 95% CI (1.05, 2.85)], ribavirin [OR = 1.54; 95% CI (1.13, 2.10)], potassium chloride [OR = 1.45; 95% CI (1.10, 1.91)], and vitamin C [OR = 1.32; 95% CI (1.03, 1.70)] were associated with increased risk, while cefathiamidine [OR = 0.29; 95% CI (0.16, 0.51)] was associated with reduced risk. Sensitivity analysis on 2,438 matched pairs revealed similar findings.Conclusion: Increased risks for suspected allergic reactions were found for the concomitant use of XYP with seven medications. Our data suggest that gentamicin, cefoperazone-sulbactam, lidocaine, and ribavirin should be applied with precautions for patients receiving XYP, and further studies on drug interactions and allergy mechanisms are warranted.

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“…Lidocaine, a commonly used local anesthetic, is reported to cause allergic reactions in some individuals. Chloroprocaine, an alternative local anesthetic, has been considered safe for patients with lidocaine allergy due to its distinct chemical structure [4]. Here, we present a case of anaphylaxis to chloroprocaine in a patient with mastocytosis and a reported lidocaine allergy.…”

Section: Introductionmentioning

confidence: 94%

A case report: Anaphylactic reaction to chloroprocaine in a patient with mastocytosis and lidocaine allergy

Richard Hazen,

Lawahidh Fali Hasham,

Danielle Kirksey

et al. 2024

World J. Bio. Pharm. Health Sci.

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This case report presents a 53-year-old woman with a history of mastocytosis and reported lidocaine allergy who experienced an anaphylactic reaction following administration of chloroprocaine during a breast biopsy procedure. The patient was promptly treated with epinephrine, methylprednisolone, famotidine, and diphenhydramine, leading to stabilization. She was subsequently transferred to the intensive care unit (ICU) for observation and discharged after 24 hours. This case highlights the importance of vigilance and preparedness for managing anaphylactic reactions in patients with mastocytosis and known allergies to local anesthetics.

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Alternative topical anesthesia for bronchoscopy in a case of severe lidocaine allergy

Cited by 4 publications

References 16 publications

Concomitant Medication Use with Xiyanping Injection and the Risk of Suspected Allergic Reactions: A Nested Case-Control Study Based on China’s National Medical Insurance Database

Concomitant Medication Use with Xiyanping Injection and the Risk of Suspected Allergic Reactions: A Nested Case-Control Study Based on China’s National Medical Insurance Database

Concomitant Medication Use With Xiyanping Injection and the Risk of Suspected Allergic Reactions: A Nested Case–Control Study Based on China’s National Medical Insurance Database

A case report: Anaphylactic reaction to chloroprocaine in a patient with mastocytosis and lidocaine allergy

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