Diagnostic evaluation of suspected local anesthetic allergy in adults: a 6-year retrospective study
Year: 2026
Type: article
Study design: Observational Study
Abstract: Although the use of local anesthetics is considered safe for minor surgical procedures, the reported frequency of adverse reactions associated with these agents remains a significant concern. Considering the administered dose of local anesthetics, it is important to recognize toxic and allergic reactions and the factors influencing them. This study aimed to evaluate the reactions in adult patients referred with suspected drug allergy, determine the frequency of true local anesthetic allergy, and investigate other types of reactions. Allergy test results were performed in 312 patients. The type, duration, and severity of the reactions were evaluated and compared with the demographic characteristics of the patients. The occurrence of reactions with the recommended alternative local anesthetic was also assessed. The results of other diagnostic tests were additionally recorded. Of the analyzed patients, 85 (27.2%) were male and 227 (72.8%) were female. The mean age was 45 years. A history of drug allergy unrelated to local anesthetics was present in 247 patients, while 65 patients (20.83%) had a history of suspected allergy to local anesthetics. Among these, lidocaine was the most frequently suspected agent in 22 patients. The specific local anesthetic agent was unknown in 30 patients. True local anesthetic allergy was confirmed in 7 of the 65 patients, while toxic epileptic seizures related to local anesthetic overdose were observed in 3 patients. In addition, true local anesthetic allergy was identified in 2 of the 247 patients with a history of drug allergy unrelated to local anesthetics. Overall, local anesthetic-related reactions were confirmed in 9 of 312 patients (2.88%), while all other test results were negative. Diagnostic testing should be performed to evaluate true allergy in patients with a history of local anesthetic reactions, and non-allergic reactions should also be considered. Drug allergies unrelated to local anesthetics may contribute to anxiety among patients and physicians. Therefore, new diagnostic algorithms are needed to evaluate not only hypersensitivity reactions but also other allergic and toxic conditions.
Authors: N.Y. Akçam, L. Çevirme, A.S. Yurtsever
Institution: Mersin Şehir Eğitim ve Araştırma Hastanesi
Language: English
Subfield: Pharmacology (medical)
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,600
OpenAlex ID: W7224756545