Kim Hyerim, Lee Jung-Man, Seo Kwang-Suk, Kwon Seok Min, Row Hyung Sang
Department of Anesthesiology and Pain Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea.
Department of Dental Anesthesiology, School of Dentistry, Seoul National University, Seoul, Korea.
J Dent Anesth Pain Med. 2019 Jun;19(3):175-180. doi: 10.17245/jdapm.2019.19.3.175. Epub 2019 Jun 30.
Although allergic reactions are not rare complications in drug use, anaphylaxis or anaphylactoid reactions to some widely used drugs can embarrass clinicians because anaphylaxis is not easily diagnosed at the time of the event and treatment is unfamiliar to many. Lidocaine is a very popular drug in dental procedures and anaphylactoid reaction to it has been rarely reported. Clinicians who use lidocaine daily should, however, be aware of the possibility of anaphylaxis after its use. Once it occurs, anaphylaxis can be fatal, but if it is quickly diagnosed or suspected, treatment is simpler than most clinicians believe. An 86-year-old woman experienced an anaphylactic reaction 30 min after local infiltration of lidocaine for retraction of retained teeth. The dentist called an anesthesiologist for assistance. Fortunately, an anaphylactic reaction was quickly suspected and after subsequent rapid treatment with the administration of fluid and drug therapy, the patient recovered completely.
尽管过敏反应在药物使用中并非罕见的并发症,但对某些广泛使用的药物发生过敏反应或类过敏反应可能会让临床医生感到棘手,因为过敏反应在发生时不易诊断,而且许多医生对其治疗并不熟悉。利多卡因在牙科手术中是一种非常常用的药物,对其发生类过敏反应的报道很少。然而,每天使用利多卡因的临床医生应该意识到使用后发生过敏反应的可能性。一旦发生,过敏反应可能是致命的,但如果能迅速诊断或怀疑,治疗比大多数临床医生认为的要简单。一名86岁女性在局部浸润利多卡因以拔除滞留牙30分钟后发生过敏反应。牙医呼叫麻醉医生寻求帮助。幸运的是,很快怀疑发生了过敏反应,随后通过补液和药物治疗进行快速治疗后,患者完全康复。