Long-term evaluation of usefulness of skin and incremental challenge tests in patients with history of adverse reaction to local anesthetics

Détails

ID Serval
serval:BIB_2A978D2DF995
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Long-term evaluation of usefulness of skin and incremental challenge tests in patients with history of adverse reaction to local anesthetics
Périodique
Allergy
Auteur(s)
Wasserfallen  J. B., Frei  P. C.
ISSN
0105-4538 (Print)
Statut éditorial
Publié
Date de publication
02/1995
Volume
50
Numéro
2
Pages
162-5
Notes
Journal Article --- Old month value: Feb
Résumé
A variety of adverse reactions to local anesthetics has been described, some of which are thought to be allergic. Different protocols of prick and intradermal skin tests as well as subcutaneous challenge tests are used to select a local anesthetic which can safely be used. Their long-term effectiveness has not yet been assessed. Twenty-eight patients with a history of adverse reaction to local anesthetics were evaluated over a 3-year period. Loss of consciousness occurred in eight patients, skin reaction in nine, and vagal symptoms in eight. Various reactions were recorded in the remaining three patients. Rapid spontaneous recovery was the rule, suggesting that immediate allergic reaction and, in particular, anaphylactic reaction were unlikely. Investigation allowed the selection of a tolerated anesthetic in all cases. Reexposure occurred in 19 patients 16-50 months after evaluation and 6.8 +/- 5.5 years after the first reaction. No patient presented a second reaction. In conclusion, adverse reactions to local anesthetics seem to be, in most cases, not allergic in nature. Evaluation protocols are effective in selecting an agent susceptible to tolerance, but are time consuming. However, they probably contribute to an important reassurance effect that is likely to increase tolerance to subsequent local anesthetic administration. Simplification of the protocols and better patient selection are proposed.
Mots-clé
Adult Aged Anesthetics, Local/*adverse effects Child Drug Hypersensitivity/*diagnosis/etiology Female Humans Intradermal Tests Male Middle Aged *Skin Tests Time Factors
Pubmed
Web of science
Création de la notice
25/01/2008 14:13
Dernière modification de la notice
20/08/2019 13:10
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