Immediate local anesthetic reactions and diagnostic test results in pediatric patients

• Ahmet Selmanoglu ^[1] ; Hakan Güvenir ^[2] ; Ilknur Kulhas Celik ^[1] ; Betul Karaatmaca ^[1] ; Müge Toyran ^[3] ; Ersoy Civelek ^[3] ; Emine Dibek Misirlioglu ^[3]
  1. [1] Ankara City Hospital, Division of Pediatric Allergy and Immunology, Ankara, Turkey.
  2. [2] Health Sciences University, Kocaeli Derince Training and Research Hospital, Department of Pediatric Allergy and Immunology, Kocaeli, Turkey.
  3. [3] Health Sciences University, Ankara City Hospital, Department of Pediatric Allergy and Immunology, Ankara, Turkey.

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• Localización: Allergologia et immunopathologia: International journal for clinical and investigate allergology and clinical immunology, ISSN-e 1578-1267, ISSN 0301-0546, Vol. 49, Nº. 3, 2021, págs. 108-114
• Idioma: inglés
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  • Background/objectives: 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.

    Patients and methods: 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.

    Results: 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.

    Conclusion: 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.