Escolano F, Aliaga L, Alvarez J, Alcon A, Olivé A
Hospital de l'Esperança, Barcelona.
Rev Esp Anestesiol Reanim. 1990 May-Jun;37(3):172-5.
We studied 35 patients which had been sent by various specialists to the Allergy department of a general hospital because they had an adverse reaction to some type of local anesthetic. The subjects underwent three types of tests: a prick test, an intradermoreaction test and a provocation test using three local anesthetics: procaine 2%, lidocaine 2%, mepivacaine 1% with no vasoconstrictors or parabens in order to rule out the possibility that the reaction was due to these substances rather than the local anaesthetic being tested. The results indicated that both the prick test and the provocation test of the local anesthetics included in the study were negative for all of the patients. One patient who had an adverse reaction to Hostacain was tested with that same anesthetic. The patient tested positive in the intradermoreaction test with a 1/10 solution but was not able to be tested with a solution free of parabens due to lack of availability. The results of our study coincide with the bibliographic research done in that real allergic reactions to local anesthetics are infrequent. The methodology used effectively distinguishes those patients with a risk of real allergic reactions there by indicating to the physician the safest local anesthetic for the patient.
我们研究了35名患者,这些患者因对某种局部麻醉剂有不良反应,由不同专科医生转诊至一家综合医院的过敏科。受试者接受了三种类型的测试:点刺试验、皮内反应试验和激发试验,使用三种局部麻醉剂:2%的普鲁卡因、2%的利多卡因、1%的甲哌卡因,均不含血管收缩剂或对羟基苯甲酸酯,以排除反应是由这些物质而非所测试的局部麻醉剂引起的可能性。结果表明,研究中所包含的局部麻醉剂的点刺试验和激发试验对所有患者均为阴性。一名对Hostacain有不良反应的患者用同一种麻醉剂进行了测试。该患者在皮内反应试验中对1/10溶液呈阳性反应,但由于无法获得不含对羟基苯甲酸酯的溶液,未能进行该溶液的测试。我们的研究结果与文献研究一致,即对局部麻醉剂的真正过敏反应很少见。所使用的方法有效地识别出有真正过敏反应风险的患者,从而为医生指明对患者最安全的局部麻醉剂。