Chlorhexidine
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Anaphylaxis: case report A 51-year-old man developed anaphylaxis twice after receiving chlorhexidine [dosage not stated]. The man was hospitalised for total hip arthroplasty. Under general anaesthesia, a urinary catheter as inserted. About 20 minutes into the procedure, after his hip was dislocated, his oxygen saturation decreased to 80%, his BP decreased to 80/50 mmHg and his HR increased to 140. The man received 100% oxygen, but his oxygen saturation did not improve. Surgery was abandoned, and he recovered and was extubated. In the recovery room, his oxygen saturation recovered to 98%. Subsequently, the operation was repeated, with insertion of a urinary catheter as before. Once again, he went into severe shock after dislocation of his hip, with oxygen saturation 85%, BP 80/50 mmHg and HR 145. Surgery was abandoned again. It was noted that he had generalised urticaria and nausea. He was intubated and received epinephrine [adrenaline], prednisolone and clemastine, and recovered quickly. He was referred for allergy testing. Skin prick test showed 3+ positive reaction to chlorhexidine 0.5%. During both procedures, a gel containing chlorhexidine [Cathejell-S] had been used to insert the urinary catheter. He subsequently underwent an uneventful total hip arthroplasty with all standard drugs administered except chlorhexidine. Sijbesma T, et al. Severe anaphylactic reaction to chlorhexidine during total hip arthroplasty surgery. A case report. HIP International 21: 630-632, No. 5, Oct 2011. Available from: URL: http://dx.doi.org/10.5301/hip.2011.8644 803064626 Netherlands
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Reactions 7 Jan 2012 No. 1383
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