Allergy Asthma Immunol Res.  2011 Oct;3(4):280-282. 10.4168/aair.2011.3.4.280.

Bronchospasm and Anaphylactic Shock Following Lidocaine Aerosol Inhalation in a Patient with Butane Inhalation Lung Injury

• Lee MY
• Park KA
• Yeo SJ
• Kim SH
• Goong HJ
• Jang AS
• Park CS

• KMID: 2167081
• DOI: http://doi.org/10.4168/aair.2011.3.4.280

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.

Keyword

Anaphylaxis; immediate hypersensitivity; inhalation; lidocaine

MeSH Terms

Anaphylaxis
Anesthesia
Anesthetics, Local
Bronchial Spasm
Bronchoscopy
Butanes
Cardiopulmonary Resuscitation
Dyspnea
Humans
Hypersensitivity
Hypersensitivity, Immediate
Inhalation
Intensive Care Units
Lidocaine
Lung
Lung Injury
Middle Aged
Resuscitation
Ventilators, Mechanical
Anesthetics, Local
Butanes
Lidocaine

Figure

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  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.

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  Fig. 2 Changes in oxygen saturation, respiratory rate, and blood pressure. CPR, cardiopulmonary resuscitation.

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