Alleged allergy to local anaesthetic drugs.
OBJECTIVE
To identify the true nature of an acute reaction in 25 patients initially diagnosed as allergic to local anaesthetic drugs.


METHODS
University General and Dental Hospitals.


METHODS
Detailed review of each patient's previous exposure to local anaesthetic drugs and of the history of the acute event was followed up with challenge testing by intradermal injection.


RESULTS
One patient was subsequently found to be genuinely allergic to a local anaesthetic drug of the amide type. A wide range of conditions had actually precipitated the other adverse reactions, but all could be classified under three major headings: an immunological condition to a different antigen; a manifestation of anxiety; or an iatrogenic problem.


CONCLUSIONS
Local anaesthetic allergy is rare, but does occur. All reactions to local anaesthetic drugs must be assessed carefully and specialist referral may be appropriate.
Wildsmith
J A
JA
University Department of Anaesthesia, Ninewells Hospital and Medical School, Dundee.
Mason
A
A
McKinnon
R P
RP
Rae
S M
SM
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000577:Amides / Q000009:adverse effects; D000707:Anaphylaxis / Q000175:diagnosis; D000779:Anesthetics, Local / Q000009:adverse effects*; D000941:Antigens / Q000276:immunology; D001007:Anxiety / Q000175:diagnosis; D002648:Child; D003937:Diagnosis, Differential; D004342:Drug Hypersensitivity / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D012882:Skin Tests
D000577:Amides; D000779:Anesthetics, Local; D000941:Antigens