Author/Editor		Košnik, M; Mušič, E; Šuškovič, S; Bajrovič, N
Title		Systemic reactions during local anesthesia: the role of allergy testing
Type		članek
Source		Allergo-J
Vol. and No.		Letnik 8, št. 2
Publication year		1999
Volume		str. 78-81
Language		eng
Abstract		Background: Although local anesthetics (LA) are generally well tolerated, patients frequently report allergy report allergy-like adverse reactions to these egents. We studied the causes of adverse reactions during local anesthesia and the role of tolerance evaluation by means of allergy testing and incremental challenge with LA in patients at risk for adverse reactions during local anesthesia. Methods: In patients referred to our department, possible mechanisms responsible for adverse eractions were established according to the history data. Patients were tested by means of skin test and incremental subcutaneous challenges with LA. Skin tests with other drugs used during procedures in local anesthesia were also performed. Thereafter questionnaires were sent to the patients. They were asked about their further local anesthesias and any adverse events. Results: Over 20 months 57 patients (51 women) 44+- 15 years old were referred for testing. In 4 Patients intradermal skin tests or challenge test were positive, but they all tolerated another LA. In three patients immediate hypersensitivity to another drug concomitantly used during local anesthesia was found. The questionnaire was answered by 25 patients. 17 patients subsequently received LA (30 injections). Sixteen pateints did not report any adverse event, while one patient reported an adverse event which was different from the adverse event before testing. Conclusion: Most adverse events during local anesthesia are nonallergic. In the case of real anaphylaxis, another drug used simultaneously with LA is a more probable cause.. Allergy skin tests and incremental challenge tests allowed the selection of at least one LA which was tolerated without immunological or toxic side effects in all patients.
Descriptors		ANESTHESIA, LOCAL SKIN TESTS DRUG HYPERSENSITIVITY QUESTIONNAIRES