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Anaphylactoid skin reactions after intravenous regional anaesthesia using 0.5% prilocaine with or without preservative — a double‐blind study
Author(s) -
Kajimoto Y.,
Rosenberg M. E.,
Kyttä J.,
Randell T.,
Tuominen M.,
Reunala T.,
Rosenberg P. H.
Publication year - 1995
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/j.1399-6576.1995.tb04170.x
Subject(s) - prilocaine , medicine , methylparaben , anesthesia , tourniquet , irritation , intradermal injection , paraben , saline , intravenous regional anesthesia , cuff , local anesthetic , propylparaben , preservative , surgery , chemistry , food science , immunology
Methylparaben, the preservative of various local anaesthetic solutions, is a potential allergen. In a double‐blind study, 0.5% prilocaine with (Citanestr̀, n=100) or without (n=100) methylparaben were compared for the occurrence of skin reactions after intravenous regional anaesthesia of the arm in surgical patients. Skin reactions were registered after the deflation of the tourniquet cuff, and intradermal tests were performed with 0.5% prilocaine, 0.1% methylparaben and saline in all patients. Seventeen patients in the Citanestr̀ group and four patients in the methylparaben‐free prilocaine group developed erythematous skin reactions in the exposed arm after deflation of the tourniquet cuff ( P <0.05, between the groups). The skin symptoms disappeared within an hour and were always restricted to the region which had been anaesthetised. None of the affected patients had positive intradermal tests. The observed skin reactions are probably non‐IgE‐mediated anaphylactoid reactions in which the presence of methylparaben in the local anaesthetic solution plays a major role.