Since the end of the 19th century, local anesthesia (LA) drugs have been used widely around the world due to their analgesic effects. True local anesthetic drug allergy is very rare. Although it is used frequently by dentists, it is used during many minor surgical procedures. Dentists in the US alone use approximately 200 million cartridges of local anesthetic drugs per year. In addition, creams and pomades containing local anesthetic are used frequently.
Local Anesthetic Drug Allergy Treatment
True allergic reactions to local anesthetics are account for less than 1% of all reactions. Systemic side effects may develop after injection of local anesthetic drug solutions. These reactions can range from transient vasovagal fainting episodes to life-threatening anaphylaxis. Preservatives of local anesthetics cause most of the reactions that occur in local drug allergies. The most effective strategy for the treatment of local anesthetic allergy is to prevent the intake of the drug or to remove it from the treatment after the drug causing the allergy is detected. Treatment should be continued with alternative drugs that have no chemical similarity or relationship with the drug group that causes allergies. Cross-reactivity between drugs must be taken into account when choosing alternative local anesthetic drugs.
All intramuscular applications should be performed in a health center where fully equipped emergency response conditions are appropriate.
Patients with a history of allergic reactions after local anesthetic drugs should be evaluated by allergists and the appropriate local anesthetic drug should be determined for treatment.
Treatment for reactions that occur in local anesthetic allergies is largely supportive and symptomatic. Drugs to be used after drug allergy that develops with local anesthetic drugs are only to control the complaints. It does not prevent the recurrence of drug allergy.
It can improve skin complaints with corticosteroid creams and oral antihistamines.
Corticosteroids can be administered orally or intravenously and can be used to treat severe systemic reactions.
In the case of anaphylaxis, the preferred treatment is adrenaline (epinephrine) administered by intramuscular injection.
The most important part in the treatment of local anesthetic drug allergies is to inform the patients and their relatives to prevent future reactions.
Written information should be given to the patient about the drugs that should be avoided. When he goes to the hospital, his doctors and health personnel must be informed and informed about the drugs he is allergic to. The patient’s family physician should be informed of the drug allergy.
Allergy bracelets/necklaces or cards indicating local anesthetic allergy created by allergists should be given to the patient.
