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Lidocaine as a Rare and Hidden Allergen in the Perioperative Setting: A Case Report

Kvisselgaard, Ask D. BSc*; Melchiors, Birgitte B. MD*,†; Krøigaard, Mogens MD*; Garvey, Lene H. PhD, MD*,‡

doi: 10.1213/XAA.0000000000000955
Case Reports

Local anesthetics are used throughout the health care system. In the perioperative setting and in other settings of exposure to local anesthetics, true allergy is reported very rarely. We present an unusual case of immediate-type perioperative hypersensitivity to lidocaine with cross-reaction to mepivacaine, which was missed on initial investigation. This case illustrates that lidocaine may be a “hidden allergen” in the perioperative setting and should always be considered a potential culprit in cases of suspected perioperative hypersensitivity. The case also demonstrates that suspected perioperative hypersensitivity requires highly specialized investigation and close collaboration between allergists and anesthesiologists.

From the *Danish Anaesthesia Allergy Centre, Allergy Clinic, Department of Dermatology and Allergology, Herlev and Gentofte Hospital, University of Copenhagen, Denmark

Department of Neuroanaesthesia, Rigshospitalet, University of Copenhagen, Denmark

Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Accepted for publication November 19, 2018.

Funding: Departmental.

The authors declare no conflicts of interest.

Address correspondence to Ask D. Kvisselgaard, BSc, Allergy Clinic UA-816GE, Gentofte Hospital, Kildegårdsvej 28, DK-2900 Hellerup, Denmark. Address e-mail to

Copyright © 2019 International Anesthesia Research Society
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