Near Fatal Anaphylactoid Reaction Due to Bupivacaine Spinal Anaesthesia
UD01-UD02
Correspondence
Dr. Prasant Kumar Singh,
Assistant Professor, Department of Surgery, All India Institutes of Medical Science, Patna-801507, Bihar, India.
E-mail: pras_doc@yahoo.com
Cardiorespiratory collapse in perioperative scenario-a dreaded occurrence, can have multiple aetiologies. Among them hypersensitivity reactions although rare, contribute significantly to patient mortality. The incidence of hypersensitivity reactions during anaesthesia have been reported to a range from 1 in 4000 to 1 in 25,000. Latex gloves and skeletal muscle relaxants are quite renowned in causing allergic reactions during perioperative period. The needle points less towards local anaesthetics, due to the rarity of such reports in literature. Also, the use of amide linked local anaesthetics for spinal anaesthesia reduces the chances of any such allergies occurring. Here, we report a case of severe anaphylactoid reaction occurring due to Bupivacaine given as a spinal anaesthetic. The extreme rarity of such reports implicating Bupivacaine as the causative agent for perioperative hypersensitivity puts this case in sharp focus. Preventing any such future episodes that are detrimental to a patient’s well-being require awareness and skill on the part of the whole team. Exploring all questionable causative agents; however, less likely or farfetched therefore becomes important.