SIDE EFFECTS OF LOCAL ANESTHETICS - ALLERGY OR OTHER UNDESIRABLE EFFECTS

Abstract

The article reviews the possible undesirable effects of local
and topically applied anesthetics, which can not be easily distinguished from true allergic reaction. After the administration of local anesthetic agents, new symptoms should be considered as a possible signs of drug adverse effect - toxicity. Adverse effects are usually caused by high plasma concentrations of the local anesthetic. Other causes and triggering factors should also be considered, such as anxiety, hyperventilation, vaso-vagal reactions, as well as reactions to epinephrine, which is frequently added to local anesthetic solutions. Because of common use of latex gloves during the medical procedures, the possibility of latex allergy should always be excluded. Hypersensitivity reactions to local anesthetics are extremely rare, they occur in less than 1 proc. of all reactions. True allergic reaction is usually due to preservative or antioxidant used in the local anesthetic solutions. Recognizing signs and symptoms of an allergy and other adverse effects to local anesthetics and administering emergency care in relation to the severity of the reaction are essential. The patient experienced adverse effect to local anesthetic should be referred to an allergist to elucidate a suspected allergy to used drug. Skin testing and incremental dose challenges can be performed if future local anesthesia is necessary. Recommendations concerning appropriate use of local anesthetics and alternative therapies in patients with documented local anesthetic allergies are given.