3079 Allergic Reactions to Local Anesthetics: Detection by Skin Tests and Subcutaneous Provocation. Analysis of 160 Cases

Tuesday, 6 December 2011
Poster Hall (Cancún Center)

Luiz Arcanjo, MD , Policlinica Geral do Rio de Janeiro, Rio de Janeiro, Brazil

Tania Maria Gonçalves Tavares, MD , Alergistas Coligados, Rio de Janeiro, Brazil

Nathalia Delcourt, MD , Policlinica Geral do Rio de Janeiro, Rio de Janeiro, Brazil

Juliana Baroni, MD , Policlinica Geral do Rio de Janeiro, Rio de Janeiro, Brazil

João Rios, MD , Policlinica Geral do Rio de Janeiro, Rio de Janeiro, Brazil

José Luiz Rios, MD , Alergistas Coligados, Rio de Janeiro, Brazil

Background:

Adverse reactions to local anesthetics (LA) are frequent and often referred to as allergic. Although immune-mediated reactions are rare, it should be investigated for suspected cases. The objective of this study was to determine the frequency of positive skin test to these drugs in patients with a suspected history of allergic reactions and describe the main socio-demographic characteristics of these individuals.

Methods:

Retrospective study of medical records of patients attended at Policlínica Geral do Rio de Janeiro Allergic Clinic, between 2008 and 2011. The parameters evaluated were the test indication and the patients age and gender. The drug tested was that the patient had a history of suspicion. Patients underwent skin prick and intradermal tests and subcutaneous provocation. Descriptive statistical analysis of the data was performed.

Results:

It was performed 160 tests (125 female). Three of this total was excluded due to inconclusive results.  In women, the highest proportion of tests was in the age group from 41 to 60 years (43%), while in males the higher concentration was at a youngest age group: 21 to 40 years (41%).

The most common indication (103 cases, 65%) for the tests was a previous   suspected anaphylactic reaction by LA.   Seven of 157 tests had a positive result (4.4%), six of them occurred in women (4.8%). Only one test resulted in a type of anaphylactic reaction response (0.67%).

All patients who presented positive response to the test had a history of per-anesthetic reaction that suggested an immune-mediated mechanism.

Conclusions:

In patients with a history of previous reaction to local anesthetics, the skin tests with these drugs have a key role in the prevention of anaphylaxis, and on guidance for adequate anesthetic procedures.