The incremental challenge test in the diagnosis of adverse reactions to local anesthetics.

Full Abstract

OBJECTIVE: The aim of this study was to assess the reliability of a diagnostic protocol, the incremental challenge test (ICT), for patients with and without a history of adverse reactions to local anesthetics (LAs) or other drugs, to select an LA that could be safely used. STUDY DESIGN: The ICT was performed on 432 subjects, 314 female and 118 male. Four hundred thirty-two challenges were carried out with LAs that were free of adrenaline and preservatives. Chi-square analysis was performed to evaluate the existence of different predispositions to ICT positivity among subjects of the 4 categories studied. RESULTS: Four hundred fifteen tests were completed with no clinical events occurring. The analysis did not show any significant difference (chi-square = 6.17; P >.05). CONCLUSIONS: Our results confirm that immunoglobulin E-mediated reactions to LAs are uncommon and that the ICT offers safety and specificity in diagnosing adverse reactions to LAs, allowing for the selection of a safe and reliable LA.

Author information

Author/s: Nettis, E (E); Napoli, G (G); Ferrannini, A (A); Tursi, A (A);

Affiliation: Department of Medical Clinic, Immunology and Infectious Diseases, Division of Allergy and Clinical Immunology, University of Bari, Italy. e.nettis(-atsign-)allergy.uniba.it

Journal and publication information

Publication Type: Clinical Trial; Journal Article

Journal: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics (Oral Surg Oral Med Oral Pathol Oral Radiol Endod), published in United States. (Language: eng)

Reference: 2001-Apr; vol 91 (issue 4) : pp 402-5

Dates: Created 2001/04/20; Completed 2001/07/12; Revised 2004/11/17;

PMID: 11312458, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

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