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Clinical Reviews in Allergy & Immunology

Published in:

28-04-2022 | Anesthetics

Allergy to Local Anesthetics is a Rarity: Review of Diagnostics and Strategies for Clinical Management

Authors: Shirley Jiang, Monica Tang

Published in: Clinical Reviews in Allergy & Immunology | Issue 2/2023

Abstract

Local anesthetics (LA) are commonly used in procedures and in topical agents for pain management. With the increasing use of LA drugs, the management of LA reactions is more frequently encountered in the office and in operating rooms. True allergic reactions involving IgE-mediated reactions and anaphylaxis are rare; they have only been identified in case reports and account for less than 1% of adverse LA reactions. Most reactions are non-allergic or are a result of hypersensitivity to other culprits such as preservatives, excipients, or other exposures. LA reactions that are misclassified as true allergies can lead to unnecessary avoidance of LA drugs or delays in surgical procedures that require their use. A detailed history of prior LA reactions is the first and most crucial step for understanding the nature of the reaction. Reactions that are suspicious for an immediate hypersensitivity reaction can be evaluated with skin prick and intradermal testing with subsequent graded challenge. Reactions that are suspicious for a delayed hypersensitivity reaction can be evaluated with patch testing.

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Title: Allergy to Local Anesthetics is a Rarity: Review of Diagnostics and Strategies for Clinical Management
Authors: Shirley Jiang
Monica Tang
Publication date: 28-04-2022
Publisher: Springer US
Keywords: Anesthetics
Anesthetics
Published in: Clinical Reviews in Allergy & Immunology / Issue 2/2023
Print ISSN: 1080-0549
Electronic ISSN: 1559-0267
DOI: https://doi.org/10.1007/s12016-022-08937-x

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