Hypersensitivity to local anaesthetics with particular reference to lidocaine
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Abstract
Local anaesthetics (LAs) found widespread application in many branches of medicine, including: dental, surgery, urology, gynecology, obstetrics, orthopedics, allowing to carry out safe and painless procedures without the need for general anaesthesia. Chemically local anaesthetics are grouped into two categories – derivatives of amide and derivatives of ester of paraaminobenzoic acid. The most popular amide group representative – lidocaine – is used as the hydrochloride at a concentration of 1% or 2% with or without epinephrine. Lidocaine is also well known because of its antiarrhythmic effect. Adverse reactions after use of LAs are usually associated with intravenous administration, use of toxic doses, hypersensitivity reactions or psychogenic reactions. True hypersensitivity reactions to LAs are rare (less than 1% of all adverse reactions). They are mediated by I or IV hypersensitivity type reactions, according to Gell and Coombs. Prick tests, intradermal tests and subcutaneous provocation tests are diagnostic methods of hypersensitivity to these drugs.
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