Immediate local anesthetic reactions and diagnostic test results in pediatric patients

Adverse reactions to local anesthetics are relatively common, but proven IgE-mediated allergy is extremely rare. We aimed to determine the frequency of local anesthetic allergy in pediatric patients. The medical records of 73 patients who presented to our clinic with a history of suspected allergic...

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Bibliographic Details
Published in:Allergologia et immunopathologia 2021-01, Vol.49 (3), p.108-114
Main Authors: Selmanoglu, Ahmet, Güvenir, Hakan, Celik, Ilknur Kulhas, Karaatmaca, Betul, Toyran, Müge, Civelek, Ersoy, Misirlioglu, Emine Dibek
Format: Article
Language:English
Subjects:
Adolescent
Anesthetics, Local - adverse effects
Anesthetics, Local - immunology
Asthma
Child
Child, Preschool
Circumcision
Diagnostic tests
Drug Hypersensitivity - diagnosis
Drug Hypersensitivity - etiology
Erythema
Female
Food allergies
Humans
Hypersensitivity, Immediate - diagnosis
Hypersensitivity, Immediate - etiology
Immunoglobulin E
Intradermal Tests
Lidocaine - adverse effects
Lidocaine - immunology
Local anesthesia
Male
Mepivacaine - adverse effects
Mepivacaine - immunology
Nonsteroidal anti-inflammatory drugs
Patients
Pediatrics
Prilocaine - adverse effects
Prilocaine - immunology
Retrospective Studies
Skin Tests
Urticaria
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Summary:Adverse reactions to local anesthetics are relatively common, but proven IgE-mediated allergy is extremely rare. We aimed to determine the frequency of local anesthetic allergy in pediatric patients. The medical records of 73 patients who presented to our clinic with a history of suspected allergic reaction to local anesthetics and underwent diagnostic testing between 2012 and 2020 were retrospectively analyzed. Diagnoses were based on case histories, skin tests, and subcutaneous challenge tests. A total of 75 test series were carried out on the 73 patients (43 boys; median [IQR] age 9.25 [7.26-14.25] years, range 3-17.8 years). The most commonly tested drugs were lidocaine (n = 38; 50.6%) and prilocaine (n = 15; 20%). Local anesthetic allergy was confirmed in one (1.3%) of the 73 patients by positive subcutaneous challenge test with mepivacaine. There are limited data in the current literature regarding local anesthetic allergies and diagnosis test results in pediatric patients. Proven local anesthetic allergy is less common than expected by society and physicians, and therefore diagnostic tests are needed for patients with no contra-indications such as severe or life-threatening reactions.
ISSN:0301-0546
1578-1267
0301-0546
DOI:10.15586/aei.v49i3.87