Allergies to local anesthetics — the real truth

Finucane, Brendan T.

doi:10.1007/bf03018730

Cited by 38 publications

(17 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The authors concluded that allergic reactions to LA are rare events, confirming the findings of other studies [139]. In general the overall incidence of allergic reactions to local anesthetics is estimated to be less that 1% [137]. …”

Section: Local Anestheticssupporting

confidence: 77%

See 1 more Smart Citation

Nonallergic Drug Hypersensitivity Reactions

Farnam

Chang

Teuber

et al. 2012

Int Arch Allergy Immunol

View full text Add to dashboard Cite

Background: Nonallergic drug hypersensitivities, also referred to as pseudoallergic or anaphylactoid reactions, have clinical manifestations that are often indistinguishable from allergic reactions. Methods: We performed a PubMed search using the terms ‘drug allergy, drug hypersensitivity, pseudoallergies, anaphylaxis and nonallergic drug reactions’ and reviewed 511 publications dated between 1970 and 2012. A total of 160 papers that were relevant to the most common nonallergic drug hypersensitivity reactions were selected for discussion. Results: Nonallergic drug hypersensitivities do not involve either IgE-mediated (type 1) or delayed (type 4) hypersensitivity. Nonallergic hypersensitivities are commonly referred to as pseudoallergic or idiosyncratic reactions. The common nonallergic drug hypersensitivities are secondary to chemotherapeutic drugs, radiocontrast agents, vancomycin, nonsteroidal anti-inflammatory agents, local anesthetic reactions and opiates. Protocols for skin testing of radiocontrast, nonsteroidal anti-inflammatory agents, local anesthetics and chemotherapeutic agents have been developed, though most have not been validated or standardized. Other diagnostic tests include in vitro-specific IgE tests, and the current ‘gold’ standard is usually an oral challenge or bronchoprovocation test. In the case of aspirin, even though it is not believed to be IgE-mediated, a ‘desensitization’ protocol has been developed and utilized successfully, although the mechanism of this desensitization is unclear. Conclusions: Diagnostic methods exist to distinguish allergic from nonallergic drug hypersensitivity reactions. The best option in nonallergic drug hypersensitivity is avoidance. If that is not possible, premedication protocols have been developed, although the success of premedication varies amongst drugs and patients.

show abstract

Section: Local Anestheticssupporting

confidence: 77%

“…However, the majority of these reactions are not true allergic reactions but rather psychosomatic, vasovagal or toxic in origin [137]. LAs contain an aromatic ring, an amine group and an intermediate chain linkage.…”

Section: Local Anestheticsmentioning

confidence: 99%

Nonallergic Drug Hypersensitivity Reactions

Farnam

Chang

Teuber

et al. 2012

Int Arch Allergy Immunol

View full text Add to dashboard Cite

show abstract

“…Although the underlying pathomechanisms of type I and type IV allergy are independent, a few cases were difficult to differentiate clinically [11]. Moreover, allergic reactions may vary from mild contact dermatitis to anaphylactic shock [9]. According to the medical history and the results of DLST of our patient, we suspected that he had type IV allergy, but the results did not confirm that he did not have type I allergy.…”

Section: Discussionmentioning

confidence: 68%

“…In clinical practice, two types of allergic reaction to LAs are recognized: IgE-mediated type I (immediate-type) allergy and T-cell mediated type IV (delayed-type) allergy [9]. In type I allergy, a rapid increase in vascular permeability as well as contraction of smooth muscles leads to symptoms such as urticaria, bronchospasm and, in severe cases, shock.…”

Section: Discussionmentioning

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

“…Its main derivative, PABA, is a common and potent sensitiser. 8 Type IV hypersensitivity (Gell and Coombs classification), e.g. contact dermatitis following exposure to LA, should be investigated by patch testing.…”

Section: Fig 1: Frequency Distribution Piechart Showing the Level Ofmentioning

confidence: 99%

Awareness Among Adult Patients Attending Ent Outpatient Department About Xylocaine Test Dose to Minor Surgical Procedure

Bhat¹,

Rao²,

Aramani³

et al. 2014

jemds

View full text Add to dashboard Cite

NEED FOR STUDY:Xylocaine is a commonly used local anesthetic for various procedures. Although the hypersensitivity to xylocaine is very infrequent, the widespread and frequent use of this drug warrants use of test dose prior to the procedure. In our study we will try to access the awareness of hypersensitivity to xylocaine amongst the patients. OBJECTIVE: To assess awareness of xylocaine hypersensitivity amongst patient undergoing procedures under local anesthesia. MATERIAL AND METHODS: 100 consecutive patients who underwent procedure under local anesthesia were presented with preforme questionnaire. And their awareness about test dose for xylocaine was assessed. RESULT: Out of 100, although 84 patients were aware of local anesthetic agent being used prior to the procedures they were undergoing, 54 had a rough idea that this drug caused allergic reactions, but only 7 patients were aware that a test dose was required. CONCLUSION: Although rare, a prior knowledge of allergic reactions caused by the local anaesthetic agents (xylocaine being the drug under study) amongst the patients might add caution to its use, as well as increase the practice of administering test dosage prior to a procedure, and hence avoiding the consequences, detectable on a test dose.

show abstract

Allergies to local anesthetics — the real truth

Cited by 38 publications

References 11 publications

Nonallergic Drug Hypersensitivity Reactions

Nonallergic Drug Hypersensitivity Reactions

Suspected Local Anesthetic Allergy of a Child: A Case Report

Awareness Among Adult Patients Attending Ent Outpatient Department About Xylocaine Test Dose to Minor Surgical Procedure

Contact Info

Product

Resources

About