Verdenking op allergie voor een lokaal anestheticum

Objective

To determine the percentage of proven allergy for local anaesthetics (LA) in patients who were tested because of a clinical suspicion of LA allergy.

Design

Retrospective multicentre case series.

Method

All patients from two hospitals who were seen from 2004 through 2013 for a possible allergy to local anaesthetics. Their records were analyzed for the probable type of allergic reaction and allergy tests were performed. Distinction was made between skin prick tests (SPT), intradermal tests (IDT), subcutaneous provocation tests and epicutaneous tests (patch tests).

Results

53 patients were included. The most common symptoms were dizziness (n = 14) and collapse (n = 12). Urticaria, oedema and/or erythema were seen in 25 patients, whilst 2 patients had a drop in blood pressure. In 4 patients an IgE-mediated allergy was proven by means of provocation testing. SPT and IDT were not predictive. In 1 patient a delayed-type allergy was established by patch testing.

Conclusion

IgE-mediated and delayed-type allergic reactions are rarely caused by LA. IgE-mediated reactions can be proven by provocation testing. Patch testing is used when a delayed type reaction is suspected.

Conflict of interest and financial support: none declared.