A Case of Anaphylactic Reaction Due to Xylocaine Jelly.

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  • キシロカインゼリー｀Ｒ´によるアナフィラキシーショック

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A case of life-threatened anaphylactic reaction by Xylocaine jelly ® was reported. A 51 year-old man who had been operated upon the neck resection due to oropharynx tumor underwent to repair a fracture of a mandibullar bone. He had a past history of having been in an anaphylactic shock with anesthetics. By the skin test, positive reactions to thiamylal, fentanyl and lidocaine for local anesthesia had been observed. Awake nasal intubation was selected because of difficulty of intubation. In the operating room, a shock followed after filling Xylocaine jelly ® into nasal cavity for inserting a nasal airway. Although endotracheal intubation was tried immediately, it brought ventricullar fibrillation and then immediate cricothyroid ligament incision allowed to be intubated. Cardioversion was successfully performed to the patient. After continuous infusion of adrenalin, the patient recovered without any sequelae.<br>In the skin test of this case, the cause to an allergic reaction was supposed to methylparaben or sodium carboxymethyl cellulose which were additives. Some additives should be considered as a cause for severe anaphylactic reaction.

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