Diagnostic evaluation of suspected local anesthetic allergy in adults: a 6-year retrospective study
- 1Department of Allergy and Immunology, Mersin City Training and Research Hospital, Mersin, Turkey
- 2Division of Immunology and Allergy Diseases, Adana City Training and Research Hospital, Adana, Turkey
- 3Department of Medical Pharmacology, Mersin City Training and Research Hospital, Mersin, Turkey
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.
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BibTeX
@article{akcam2026diagnostic,
title = {{Diagnostic evaluation of suspected local anesthetic allergy in adults: a 6-year retrospective study}},
author = {N.Y. Akçam and L. Çevirme and A.S. Yurtsever},
journal = {Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas},
year = {2026},
month = oct,
doi = {10.1590/1414-431x2026e15704},
url = {https://europepmc.org/article/PMC/PMC13722000},
note = {CC BY},
}
RIS
TY - JOUR
TI - Diagnostic evaluation of suspected local anesthetic allergy in adults: a 6-year retrospective study
AU - N.Y. Akçam
AU - L. Çevirme
AU - A.S. Yurtsever
PY - 2026
DA - 2026/10/30
JO - Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas
DO - 10.1590/1414-431x2026e15704
UR - https://europepmc.org/article/PMC/PMC13722000
AB - 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.
SN - 0100-879X
SN - 1414-431X
ER -