对酰胺类局部麻醉药的真正过敏反应：综述与病例报告
True Allergy to Amide Local Anesthetics: A Review and Case Presentation.
作者信息
Bina Babak, Hersh Elliot V, Hilario Micael, Alvarez Kenia, McLaughlin Bradford
机构信息
Director General Practice Residency, NYU Lutheran, Brooklyn, New York.
Professor of Oral Surgery and Pharmacology, University of Pennsylvania School of Dental Medicine, Philadelphia.
出版信息
Anesth Prog. 2018 Summer;65(2):119-123. doi: 10.2344/anpr-65-03-06.
Adverse reactions to local anesthetics are usually a reaction to epinephrine, vasovagal syncope, or overdose toxicity. Allergic reactions to local anesthetics are often attributed to additives such as metabisulfite or methylparaben. True allergic reactions to amide local anesthetics are extremely rare but have been documented. Patients with true allergy to amide local anesthetics present a challenge to the dental practitioner in providing adequate care with appropriate intraoperative pain management. Often, these patients may be treated under general anesthesia. We report a case of a 43-year-old female patient that presented to NYU Lutheran Medical Center Dental Clinic with a documented history of allergy to amide local anesthetics. This case report reviews the use of 1% diphenhydramine with 1:100,000 epinephrine as an alternative local anesthetic and reviews the relevant literature.
局部麻醉药的不良反应通常是对肾上腺素、血管迷走性晕厥或用药过量毒性的反应。对局部麻醉药的过敏反应常归因于亚硫酸氢盐或对羟基苯甲酸甲酯等添加剂。对酰胺类局部麻醉药的真正过敏反应极为罕见，但已有文献记载。对酰胺类局部麻醉药真正过敏的患者给牙科医生在提供充分护理及适当的术中疼痛管理方面带来了挑战。通常，这些患者可能需要在全身麻醉下接受治疗。我们报告一例43岁女性患者，她到纽约大学路德医疗中心牙科诊所就诊时，有酰胺类局部麻醉药过敏的记录病史。本病例报告回顾了1%苯海拉明与1:100,000肾上腺素作为替代局部麻醉药的使用情况，并回顾了相关文献。
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