Adverse reactions to local anesthetics: Analysis of 197 cases

Gall, H.; Kaufmann, Roland; Kalveram, C. M.

doi:10.1016/s0091-6749(96)80067-4

Cited by 181 publications

(112 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although well known, they rarely induce adverse effects related to overdose or accidental intravascular administration [88]. In exceptional cases, they induce hypersensitivity reactions; these have been mainly described as relating to the amide group [39,89].…”

Section: Non-steroidal Anti-inflammatory Drugs (Nsaids) Nsaids Are Rmentioning

confidence: 99%

Practical Guidelines for Perioperative Hypersensitivity Reactions

Laguna¹,

Archilla²,

Doña³

et al. 2018

J Investig Allergol Clin Immunol

105

View full text Add to dashboard Cite

Perioperative hypersensitivity reactions constitute a first-line problem for anesthesiologists and allergists, so it is advisable that hospitals have a consensus protocol for the diagnosis and management of these reactions. However, this kind of protocols is not present in many hospitals, leading to problems in treatment, the communication of incidents and subsequent etiological diagnosis. In this document we present a systematic review of the available scientific evidence and provide general guidelines for the management of acute episodes and Resumen:Las reacciones de hipersensibilidad perioperatorias constituyen un problema de primera línea para los anestesiólogos y alergólogos, por lo que es recomendable que los hospitales tengan un protocolo de consenso para el diagnóstico y el tratamiento de estas reacciones. Sin embargo, este tipo de protocolos no está presente en muchos hospitales, lo que conlleva problemas en el tratamiento, la comunicación de incidentes y el posterior diagnóstico etiológico. Este documento ha sido creado por miembros del Comité de Alergia a Medicamentos de la Sociedad Española de Alergia e Inmunología Clínica (SEAIC) en colaboración con miembros de la Sociedad Española de Anestesia (SEDAR). Se ha realizado una revisión sistemática de la evidencia científica disponible y se proporcionan pautas generales para el manejo de episodios agudos y para la derivación de pacientes con reacciones de hipersensibilidad perioperatoria a los Servicios de Alergología. Se propone un algoritmo práctico para el diagnóstico etiológico y se brindan recomendaciones para el manejo de pacientes con reacciones alérgicas perioperatorias.

show abstract

Section: Non-steroidal Anti-inflammatory Drugs (Nsaids) Nsaids Are Rmentioning

confidence: 99%

Practical Guidelines for Perioperative Hypersensitivity Reactions

Laguna¹,

Archilla²,

Doña³

et al. 2018

J Investig Allergol Clin Immunol

105

View full text Add to dashboard Cite

show abstract

“…Immunological reactions to local anaesthetics, particular the newer amides, however, remain anecdotal and symptoms usually result from vasovagal episodes or anxiety reactions (178,(181)(182)(183). Acute disorientation or seizures may occur after overdosage or inadvertent intravenous injection.…”

Section: Local Anaestheticsmentioning

confidence: 99%

Anaphylaxis during anaesthesia: diagnostic approach

Ebo¹,

Fisher²,

Hagendorens³

et al. 2007

Allergy

195

197

View full text Add to dashboard Cite

Anaesthesiologists administer several drugs while providing general anaesthesia. Many of these drugs can elicit adverse drug reactions that fall apart into two major types. First, reactions that are usually dose-dependent and related to the pharmacological properties of the drug and/or its metabolites. Second, reactions that are unrelated to the drug's pharmacological characteristics and that are less dose-dependent. These reactions comprise drug intolerance, idiosyncratic reactions and drug-induced immune-mediated allergic and nonimmune-mediated so-called pseudo-allergic or anaphylactoid reactions. The terms anaphylactic and anaphylactoid, however, have been used inconsistently in the literature. Therefore, the nomenclature task force set up by the European Academy of Allergy and Immunology (EAACI) has proposed that anaphylactic-type reactions should be reclassified into allergic anaphylaxis and nonallergic anaphylaxis. Allergic anaphylaxis being further subdivided in IgE-mediated and non-IgE-mediated reactions (1).The exact prevalence of anaphylaxis during anaesthesia is difficult to ascertain. The estimated overall frequency has been reported to vary between 1 in 3500 and 1 in 13 000 procedures in French series (2, 3) and between 1 in 10 000 and 1 in 20 000 in an Australian study (4). The clinical manifestation of these reactions is not infrequently an almost immediate generalized response with bronchospasm and hypotension. The degree of severity varies and does not allow differentiation between an IgE-mediated or non-IgE mediated reaction resulting from nonspecific mediator release (5). The mortality from these reactions is in the range from 3 to 6%, and an additional 2% of patients experience significant residual brain damage (4).Diagnosis of anaphylaxis during anaesthesia is not always straightforward. It can be hampered as a broad spectrum of different drugs can elicit heterogeneous allergic and nonallergic reactions with distinct and sometimes unclear pathological mechanisms. Problems are certainly compounded as multiple drugs need to be administered during general anaesthesia. In addition, nonanaesthesia related drugs or procedures (e.g. disinfection) are sometimes administered/performed in the perioperative period and can also be the cause of an allergic reaction.In addition, none of the available diagnostic tests demonstrates absolute accuracy. False-positive test Correct management of anaphylaxis during anaesthesia requires a multidisciplinary approach with prompt recognition and treatment of the acute event by the attending anaesthesiologist, and subsequent determination of the responsible agent(s) with strict avoidance of subsequent administration of all incriminated and/or cross-reacting compounds.However, correct identification of the causative compound(s) and safe alternatives is not always straightforward and, too often, not done.This review is not intended to discuss acute management of anaesthesia-related anaphylaxis but summarizes the major causes of anaphylaxis during anaesthesia and the di...

show abstract

“…Prior to his next dental appointment, we planned his treatment on the basis of the literature [1][2][3][4][5][6][7][8] (Figure 1). In our searching for the cause of his skin rashes, we suspected him as having LA allergy not influenza, because he presented with typical symptoms of allergy such as rashes that are different from those in influenza.…”

Section: Case Reportmentioning

confidence: 99%

“…Although hypersensitivity reactions are especially rare and account for less than 1% of all adverse reactions, exposure to allergens can cause a lifethreatening allergic reaction known as anaphylactic shock [1][2][3][4]. We sometimes encounter patients who believe that they have LA allergy on the basis of their experiences of developing various symptoms after injection of LAs.…”

Section: Introductionmentioning

confidence: 99%

Suspected Local Anesthetic Allergy of a Child: A Case Report

Matsumura¹,

Miyamoto²,

Fukayama³

2017

Pediatr Dent Care

View full text Add to dashboard Cite

In dental practice, a certain number of patients complain of various symptoms after injection of local anesthetics. However, especially in children who cannot express their symptoms properly, a correct diagnosis of local anesthetic allergy is difficult. Here is a case of a boy with suspected local anesthetic allergy. We looked for an alternative local anesthetic on the basis of the medical history and the results of allergy tests.

show abstract

Adverse reactions to local anesthetics: Analysis of 197 cases

Cited by 181 publications

References 12 publications

Practical Guidelines for Perioperative Hypersensitivity Reactions

Practical Guidelines for Perioperative Hypersensitivity Reactions

Anaphylaxis during anaesthesia: diagnostic approach

Suspected Local Anesthetic Allergy of a Child: A Case Report

Contact Info

Product

Resources

About