Pharmacovigilance for chlorhexidine anaphylaxis: a preventable adverse reaction

Suran L Fernando, Marc J Capon, Sarah L Green and Michael J Boyle
Med J Aust 2021; 214 (4): . || doi: 10.5694/mja2.50929
Published online: 1 March 2021

A 73‐year‐old man underwent a right total right knee replacement for osteoarthritis. He had a background of ischaemic heart disease with previous coronary artery bypass grafting, diabetes mellitus and gout. His medications before surgery were aspirin, metformin, frusemide, atorvastatin, paracetamol, sotalol, ramipril and allopurinol. Sixteen minutes after spinal anaesthesia comprising bupivacaine, fentanyl and morphine in addition to intravenous (IV) midazolam, cefazolin and tranexamic acid, he developed anaphylaxis characterised by hypotension (systolic blood pressure, 60 mmHg), and generalised pruritus requiring IV metaraminol and adrenaline. His condition stabilised to allow completion of the procedure.

  • 1 Royal North Shore Hospital, Sydney, NSW
  • 2 University of Sydney, Sydney, NSW
  • 3 John Hunter Hospital, Newcastle, NSW
  • 4 University of Newcastle, Newcastle, NSW

Competing interests:

No relevant disclosures.


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