2025 Volume 32 Issue 7 Pages 174-178
Perioperative anaphylaxis caused by amide-type local anesthetics is rarely reported. We experienced a case of anaphylactic shock following wound infiltration anesthesia with an amide-type local anesthetic agent. The patient, a 46-year-old man, underwent an elective laparoscopic colectomy. Wound infiltration anesthesia with 40 ml of 0.33％ ropivacaine resulted in urticaria on the trunk and slight decrease in blood pressure. Despite suspecting an allergic reaction to ropivacaine, blood pressure was maintained with the administration of ephedrine. As there was no increase in airway pressure, tracheal extubation was successfully performed without administering adrenaline. However, 20 minutes later returning to the ward, the patient's blood pressure decreased, leading to a diagnosis of anaphylactic shock. An intramuscular injection of 0.3 mg of 0.1％ adrenaline was administered, and there was no recurrence of symptoms. A diagnosis of ropivacaine-induced anaphylaxis was made based on a positive skin test to ropivacaine performed later.
