Abstract: Objective To study the characteristics and regularity of anaphylactic shock induced by lidocaine and provide reference for clinical application. Methods Three cases of anaphylactic shock developed after administration of lidocaine between October 1, 2016 and December 31, 2019 in the National Cancer Center were analyzed. Literature related to anaphylactic shock that was published as of December 2019 was retrieved from such databases as Pubmed, CNKI and Wanfang. Results A total of 191 cases were collected. The median age was 35 years old and the ratio of males to females was 1：1.15. Among these cases, 57 (29.8%) had a history of allergy, 155 (81.2%) developed anaphylactic shock within 10 minutes of lidocaine use, 164 (85.9%) recovered and 27 cases (14.1%) died. The mortality rate, which varied according to the onset time of shock, was statistically different not only between the group with an onset time ≤5 min and the group with an onset time of 5 min<t≤10 min, but also between the group under topical anesthesia and the group with local infiltration. Conclusion The occurrence and fatality of anaphylactic shock induced by lidocaine may be related to the allergy history of local anesthetics, dosage and ways of anesthesia. Clinicians should inquire about the allergy history in detail, choose proper dosage and speed of administration and monitor patients in the whole course of lidocaine use.

Key words: lidocaine, anaphylactic shock, local anesthetics, adverse drug reaction