A case report of anaphylactic shock caused by lidocaine.

RATIONALE: Local anesthesia is a widely used technique for emergency wound closure, with lidocaine among the most commonly employed local anesthetics. Allergic reactions to lidocaine are rare, with anaphylaxis being even more uncommon.

PATIENT CONCERNS AND DIAGNOSIS: This report describes a 72-year-old male patient who presented with a right foot injury and underwent wound suturing under lidocaine local anesthesia. Although the procedure went smoothly, the patient developed dizziness, cold sweats, hypotension, and bradycardia 30 minutes later, leading to a diagnosis of anaphylaxis due to lidocaine allergy.

INTERVENTIONS AND OUTCOMES: Immediate treatment for anaphylactic shock was initiated, including intramuscular administration of adrenaline, fluid resuscitation, anti-inflammatory agents, antihistamines, oxygen therapy, and symptomatic supportive care. Within 20 minutes of active treatment, the patient's symptoms were effectively controlled. The patient was safely discharged after 24 hours of observation. Health education was provided to enhance self-management skills.

LESSONS: Although rare, anaphylaxis induced by lidocaine can be fatal. Early recognition, prompt intervention, thorough preoperative assessment, and careful postoperative monitoring are critical to improving survival rates.