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BJA Advance Access originally published online on November 5, 2008
British Journal of Anaesthesia 2009 102(1):65-68; doi:10.1093/bja/aen324
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Anaphylaxis to the chlorhexidine component of Instillagel®: a case series

A. W. Parkes1, N. Harper1,*, A. Herwadkar2 and R. Pumphrey2

1 Department of Anaesthesia
2 Department of Clinical Immunology, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK

* Corresponding author. E-mail: nigel.harper{at}manchester.ac.uk

Anaphylaxis to chlorhexidine is rare. We report three cases of anaphylaxis attributed to the chlorhexidine component of Instillagel®, presenting after urological surgery, while the patients were in the recovery room. In these cases, the cause of the collapse was not immediately obvious as the presentation was delayed. Anaesthetists should be aware that urethral lubricants may contain chlorhexidine that can trigger anaphylaxis in susceptible individuals. Anaphylaxis should be considered a possible diagnosis when a patient collapses in the recovery room. Investigation of suspected anaphylactic reactions related to anaesthesia is important to try and identify a likely trigger for a reaction and to help prevent further exposure and potential harm.

Keywords: allergy, chlorhexidene; complications, anaphylaxis; complications, postoperative; equipment, lubricant gel; surgery, urological


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E-letters:

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Allergy to preservatives
Craig A Patterson
British Journal of Anaesthesia, 11 Dec 2008 [Full text]
Chlorhexidine anaphylaxis in Auckland.
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British Journal of Anaesthesia, 5 Feb 2009 [Full text]

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