Rare case of unforeseen tragic event of severe anaphylactic reaction to lidocaine in a paediatric patient in rural low resource setup

Abstract

Anaphylactic reaction to lidocaine is a very rare and life-threatening event. Lidocaine (xylocaine) is one of the most common anaesthetic drugs used as local anaesthetics for minor dental and other minor surgical procedure. Although minor allergic reactions after administration of lidocaine are common and easily resolved after just antihistaminic with or without steroid administration. However severe anaphylaxis leading to death is very rare; so much that the physicians might be unaware of its occurrence and its emergency management. From 1957 to 2012, there were seven reports of single case and one report of 8 cases with sufficient information for review. In paediatric patients, very few have history of allergies and due to unawareness of their allergic condition they may land in tragic event of anaphylaxis which if not managed on time can lead to death. We hereby presented such a rare case of a 14 years old female posted for a minor surgical procedure, who had anaphylactic shock due to lidocaine, followed by sudden cardiorespiratory arrest leading to death despite of all the prompt management.