Local anaesthetic creams and intradermal skin tests

Simons, F. E. R.; Gillespie, C. A.; Simons, K. A.

doi:10.1016/0140-6736(92)91994-j

Cited by 15 publications

(6 citation statements)

References 5 publications

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“…The pain associated with allergy skin tests significantly decreases with the use of topical anesthetic, as clearly demonstrated in previous studies 20,21,22. However, in those studies, IDT were performed with aeroallergens20 or only with histamine and saline controls 21,22.…”

Section: Discussionmentioning

confidence: 71%

“…The use of a topical anesthetic cream containing lidocaine-prilocaine also significantly reduces pain associated with allergy skin tests, as proven in previous studies 20,21,22. However, because lidocaine-prilocaine acts on the skin, changing basal skin perfusion,23 concerns have been raised that the use of EMLA® for alleviating pain caused by IDT could interfere with the wheal and flare response by modifying the number of recruited sensitized cells 24.…”

Section: Introductionmentioning

confidence: 84%

“…However, in those studies, IDT were performed with aeroallergens20 or only with histamine and saline controls 21,22. To the best of our knowledge, this is the first time that the effects of EMLA® on the readings of IDT with drugs have been investigated.…”

Section: Discussionmentioning

confidence: 99%

“…However, this was not the aim of our study. For that purpose, the study should have been blind, but that has already been reported in previous literature 20,21,22. We did not include SPT as part of our study, since they are much less painful than IDT and therefore the use of an expensive anesthetic patch is less likely to be necessary.…”

Section: Discussionmentioning

confidence: 99%

“…The first placebo-controlled study showed that EMLA® did not decrease the mean wheal and flare areas after saline and did not decrease the mean wheal area after histamine; nevertheless, for the flare area, a significant decrease was observed in those with EMLA® application compared to placebo for the injection of histamine 0.1 mg/mL 22. It should be noted, however, that this effect was only evidenced with this concentration and did not occur with histamine at 10 mg/mL, which is the recommended concentration for allergy testing.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Intradermal Tests for Diagnosis of Drug Allergy are not Affected by a Topical Anesthetic Patch

Couto

Silva

Ferreira

et al. 2014

Allergy Asthma Immunol Res

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The use of topical anesthesia to perform intradermal tests (IDTs) for drug allergy diagnosis was never investigated. We aimed to determine the effects of a topical anesthetic patch containing prilocaine-lidocaine on wheal size of IDT with drugs. Patients who had positive IDT as part of their investigation process of suspected drug hypersensitivity were selected. IDT were performed according to guidelines. Anesthetic patch (AP) was placed and the same prior positive IDT, as well as positive histamine skin prick test (SPT) and negative (saline IDT) controls, were performed in the anesthetized area. Patients with negative IDT were also included to check for false positives with AP. Increase in wheals after 20 minutes both with and without AP was recorded and compared. 45 IDT were performed (36 patients), of which 37 have been previously positive (14 antibiotics, 10 general anesthetics, 6 non-steroidal anti-inflammatory drugs, 3 iodinated contrasts, 3 anti-Hi-histamines and 1 ranitidine). Mean histamine SPT size without the AP was 4.7 mm [95%CI (4.4-5.1]), and 4.6 mm [95%CI(4.2-5.0)] with anesthesia. Mean wheal increase in IDT for drugs without the anesthesia was 4.5 mm [95%CI(3.3-5.7)] and with anesthesia was 4.3 mm [95%CI(2.8-5.8)]. No statistical significant differences were observed between skin tests with or without AP for histamine SPT (P=0.089), IDT with saline (P=0.750), and IDT with drugs (P=0.995). None of the patients with negative IDT showed positivity with the AP, or vice-versa. The use of an AP containing prilocaine-lidocaine does not interfere with IDT to diagnose drug allergy, and no false positive tests were found.

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Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Intradermal Tests for Diagnosis of Drug Allergy are not Affected by a Topical Anesthetic Patch

Couto

Silva

Ferreira

et al. 2014

Allergy Asthma Immunol Res

View full text Add to dashboard Cite

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Multifactorial analysis of p53 alteration in human cancer: A review

Soussi

Legros

Lubin

et al. 1994

Intl Journal of Cancer

293

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Use of eutectic mixture of local anesthetics in children

Dutta

1999

Indian J Pediatr

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The Eutectic Mixture of Local Anesthetics (EMLA) is a topical application, which has proved to be a useful medication for providing pain relief among children. It is an emulsion containing a 1:1 mixture of lidocaine and prilocaine. The high concentration of the uncharged anesthetic base in the microdroplets of the emulsion ensure effective skin penetration. In the pediatric population EMLA has been shown to be efficacious when it is used prior to venipuncture, cannulation, lumbar puncture, laser treatment of port wine stains, curettage of molluscum contagiosum or vaccination. For several of these indications, the efficacy has been documented by double blind controlled trials, that have used objective and quasi-objective scales for assessing pain relief. The dose of EMLA is between 0.5 to 1 gram, and the cream should be applied half to one hour prior to the procedure. Local side effects are very mild, and the only systemic side effect of importance is the risk of methemoglobinemia in young infants. The literature has conflicting reports about the safety of EMLA in neonates.

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Local anaesthetic creams and intradermal skin tests

Cited by 15 publications

References 5 publications

Intradermal Tests for Diagnosis of Drug Allergy are not Affected by a Topical Anesthetic Patch

Intradermal Tests for Diagnosis of Drug Allergy are not Affected by a Topical Anesthetic Patch

Multifactorial analysis of p53 alteration in human cancer: A review

Use of eutectic mixture of local anesthetics in children

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