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**Case Report: Allergic Shock Induced by Lidocaine**
**Journal No Reports.**
One case of allergic shock caused by lidocaine has been reported. The patient was from Jiutai City, treated at a hospital in its Quinoline Library Department by Dr. Yan. The patient, a 14-year-old male child, was in generally good condition but had cyanosis which improved. His blood pressure was maintained at 11/8 kPa with a weight of 35 kg.
The child was hospitalized for a fracture of the right forearm radius bone in 1991, receiving continuous oxygen and intravenous infusions of dexamethasone. After admission, his blood pressure was stabilized using a small splint for 7 days, with no new bleeding occurring. On the next day, around 9 a.m., the child appeared slightly unwell. At 8 a.m., it was noted that his breathing and blood pressure were stable, though systemic urticaria (hives) had not yet subsided. An axillary brachial plexus block was planned for open reduction and internal fixation, with only intravenous drugs administered.
The next day, during routine pre-operative disinfection of the armpit skin, an axillary artery puncture was performed under ketamine anesthesia. A 1% lidocaine solution was injected into the pulsating point on the side of the fracture for scheduled surgery. After the procedure, the child experienced difficulty breathing. He developed systemic urticaria-like rashes, conjunctival congestion, low blood pressure, and cyanosis of the lips. Blood tests confirmed positive skin reactions, consistent with an allergic reaction to lidocaine.
Upon entering the operating room, the child's blood pressure dropped from 14 kPa/10 kPa to 9.5 kPa/7 kPa due to the local anesthetic. Intravenous administration of 25% glucose (100 ml) plus lactams was given, which is rare. The patient received risedronate betamethasone (10 mg) intravenously, diluted in 5% glucose (500 ml). This might be related to specific physiological factors. Additionally, 10 mg of dexamethasone and 10 mg of Alaska were administered intramuscularly for safety. In clinical settings, lidocaine is commonly used; however, occasional allergic reactions may occur. Dutch hood pressurized oxygen was administered, and the child became calmer.
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**Case Report: Periodic Flaccid Paralysis Caused by Indomethacin**
Reported by Lingui Ling and Pham Van from the Chaoyang District People’s Hospital of Changchun City.
A 29-year-old female patient presented with normal menstrual cycles until November 1989. Following a head CT and magnetic resonance imaging, she experienced flaccid paralysis in her limbs the next day, while remaining fully conscious. Initial examinations, including EEG, were normal. The patient experienced recurrent episodes of flaccid paralysis every 1–2 days after menstruation. Each episode was followed by anxiety and blood-like secretions. Her menstrual flow was moderate, and she suffered from dysmenorrhea. Blood sugar levels were monitored during each episode, and ECG showed no abnormal vital signs.
Examinations revealed: body temperature 36.8°C, pulse 84 beats/min, respiratory rate 18 breaths/min, and blood pressure 14.5/11.9 kPa. No treatment was initially administered. Detailed medical history revealed that the patient experienced joint pain and swelling due to diamine exposure 10 months prior. Laboratory tests showed no abnormalities in blood cardioplegia. During episodes, the patient exhibited flaccid paralysis in her limbs, with knee tendon reflexes reduced to 30 mm/day-inch. Anti-O titer was 800 units. Diagnoses included hyporeflexia and absence of pathological reflexes.
Urgent inspections revealed heart conditions resembling rheumatoid arthritis. Oral indomethacin was prescribed for three days. Electrolyte levels (potassium, sodium, chloride, calcium, phosphorus) and blood glucose were tested, yielding results within normal ranges. It was considered that the patient might have juvenile periodic flaccid paralysis.
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