• A&A practice · Nov 2023

    Case Reports

    Delayed Nonimmune Anaphylaxis Caused by Ropivacaine for Preoperative Nerve Blocks: A Case Report.

    • Tomomi Ishii, Hirotsugu Miyoshi, Takashi Kubo, Yasuo M Tsutsumi, Yousuke T Horikawa, and Hiroyuki Tanaka.
    • From the Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan.
    • A A Pract. 2023 Nov 1; 17 (11): e01727e01727.

    AbstractRopivacaine is an amide local anesthetic with rare reports of anaphylaxis. To our knowledge, this is the first report of delayed nonimmune anaphylaxis induced by ropivacaine. A 70-year-old man underwent general anesthesia with a nerve block for a total knee arthroplasty. The patient developed symptoms of anaphylaxis 3.5 hours after receiving ropivacaine for femoral and tibial nerve blocks. A basophil activation test (BAT) revealed ropivacaine as the causative agent. Notably, anaphylaxis can be caused by medications even hours after their administration, and all administered drugs should be suspected of potentially causing anaphylaxis.Copyright © 2023 International Anesthesia Research Society.

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