Local anesthetics exacerbate antibiotic-induced anaphylactic shock

摘要

Anaphylactic shock is a severe form of allergic reaction that begins suddenly and may cause death. We describe a male patient with rectal cancer who was undergoing low anterior resection and transverse colostomy developed anaphylactic shock following ultrasound-guided transversus abdominis plane (TAP) block and prophylactic antibiotics injection. The acidosis and hypoxia due to shock markedly potentiate the cardiotoxicity of local anesthetics which may exacerbate the anaphylactic shock. Besides the treatment for the shock episode, immediate using lipid emulsion in the patient developing antibiotics related anaphylactic shock with local anesthetics administration maybe helpful.