Allergic Reactions to Local Anesthetics in Dental Patients: Analysis of Intracutaneous and Challenge Tests

Abstract

Some dental patients have histories of adverse reactions to local anesthesia. The aim of the present study was to investigate the frequency of allergy to local anesthetics of dental patients who had histories of adverse reactions to local anesthesia based on the results of allergy tests in our institute over a period of 5 years. We investigated the past medical records of dental patients retrospectively, and twenty patients were studied. Three of the 20 showed a positive or false-positive reaction in the intracutaneous test, and one patient showed a false-positive reaction in the challenge test. Our results suggest that the frequency of allergy to local anesthetics is low even if patients have histories of adverse reactions to local anesthesia. However, allergy tests of local anesthetics should be performed in patients in whom it is uncertain whether they are allergic.

Pre- Versus Post-Tonsillectomy Intraoperative Bupivacaine Injection in the Pediatric Population: An Age- and Surgical Indication-Stratified Analysis

“…In patients with OSA and SDB, opioid use is carefully titrated or even avoided due to the risk of apnea and desaturation. 26 Our results imply a lack of significant benefit from bupivacaine in patients with OSA or SDB and suggest against potentially unnecessary intraoperative intervention using the local anesthetic.…”

A case of contact dermatitis due to dental surface anaesthetic

“…However, true allergic reactions are considered to occur in less than 1% of all adverse reactions to local anaesthetics 2 . Allergy to local anaesthetics is thought to be a type IV reaction with occurrence rates between 80% and 90%, 3 meaning that most of them occur as allergic contact dermatitis 3 . Because benzocaine is often contained in over‐the‐counter drugs, it is necessary to enquire about the history of allergies to topical drugs when performing surface anaesthesia.…”

<p>Successful Dental Treatments Using Procaine Hydrochloride in a Patient Afraid of Local Anesthesia but Consenting for Allergic Testing with Lidocaine: A Case Report</p>

“…When an abnormality of the overall general status is found during local anesthesia in dentistry, 3 , 7 , 9 the patient is often referred to the university hospital with the suspicion of allergic reactions to the local anesthetic. Although we carefully recorded the patient’s medical history, it was difficult to obtain a precise diagnosis for her allergic reactions to local anesthetics.…”