Allergic reaction caused by articaine

Abstract

We report the case of a 51-year-old woman who had an immediate skin reaction after subcutaneous administration of a local anesthetic (LA) composed of articaine and epinephrine before a dental procedure. The patient subsequently underwent further dental procedures without LA. Skin prick tests performed with commercial LAs (lidocaine, mepivacaine, bupivacaine and articaine) were negative with epinephrine and all LAs except articaine. In 10 healthy controls, skin prick tests with articaine were negative. Subcutaneous challenge test with mepivacaine (0.3 and 0.5 ml) was negative. Provocations with the remaining anesthetics of the amide group were not carried out due to the patient's refusal.

Effect of articaine on mental nerve anterior portion: Histological analysis in rats

“…There are some reports of undesirable effects related to articaine use in dentistry [32][33][34]; however, most of them involve isolated cases. Unlike studies that support the hypothesis that articaine has neurotoxic potential, Leuschner and Leblanc [23] documented no pathomorphological systemic changes after the administration of 4% articaine in rats and dogs, even at toxic doses.…”

Use of Articaine in loco-regional anesthesia for day care surgical procedures

“…Presence of antioxidant sodium bisulphite and antibacterial preservative methylparaben in some commercially available preparations of articaine with epinephrine can cause allergic reactions such as edema, urticaria, erythema and anaphylactic shock. [14] Some local anesthetics can cause methemoglobinemia but articaine is not associated with any increase in the levels of methemoglobin. [15] Overdose can cause unconsciousness, apnoea, hypotension, hypoxia, bradycardia and may initiate seizure activity.…”

Comparison of 4% articaine and 0.5% bupivacaine anesthetic efficacy in orthodontic extractions: Prospective, randomized crossover study

“…The available literature indicates that articaine is equally effective when compared with other LAs. 12,13 Articaine is an amide derivative with a thiophene ring in its molecular structure (Fig. 1, Table 1) instead of the usual benzene ring, making it more lipophilic and thus accounting for its faster diffusion properties within tissues and bones, resulting in profound anesthesia and rapid time of anesthetic onset when compared with bupivacaine.…”

“…The main metabolic product is articainic acid (or more accurately, articainic carboxylic acid), which is nontoxic and inactive as an LA. 13 The onset of anesthesia was assessed by the pin prick test. Upon the onset of anesthesia, there was no sensitivity in the associated mucosa after probing it with a Moon probe.…”