Shapira J, Rubinow A
Anesth Prog. 1987 Sep-Oct;34(5):191-4.
The clinical histories of four children with a history of adverse reactions to local anesthesia and who required dental treatment are reviewed retrospectively. The children described had been referred to the allergy unit for evaluation between 1984 and 1985 and are representative of the dilemma of cases of suspected hypersensitivity to local anesthetics. The first two cases had been previously treated without the use of regional anesthesia because of a family history of atopic reactions as well as equivocal skin testing to local anesthetic. The third child had experienced bizarre adverse reactions to a variety of foods and detergents erroneously interpreted as possible deterrents to the use of local anesthetics. All four children were challenged with progressively increasing concentrations of lidocaine according to a described protocol. In three cases no reaction was observed and dental procedures were performed without difficulty using lidocaine for local anesthetics. A history of bronchoconstriction in the fourth child and the contradictory results of skin tests to local anesthetics, prompted the administration of pretreatment medication aimed at preventing bronchial hyperactivity related to dental anesthesia.
回顾性分析了4例有局部麻醉不良反应史且需要牙科治疗的儿童的临床病史。所述儿童于1984年至1985年间被转诊至过敏科进行评估，代表了疑似对局部麻醉药过敏病例的困境。前两例因有特应性反应家族史以及对局部麻醉药皮肤试验结果不明确，此前未使用区域麻醉进行治疗。第三个孩子对多种食物和洗涤剂有奇怪的不良反应，曾被错误地解释为可能妨碍使用局部麻醉药。根据所述方案，对所有4名儿童使用浓度逐渐增加的利多卡因进行激发试验。3例未观察到反应，使用利多卡因进行局部麻醉时牙科手术顺利进行。第四个孩子有支气管收缩病史且对局部麻醉药皮肤试验结果相互矛盾，因此给予了旨在预防与牙科麻醉相关的支气管高反应性的预处理药物。
