Allergy tests for anesthetics

Determination of sensitivity to dental anesthetics.

Allergic reactions to local anesthetics are known to include two types of reactions: immunoglobulin E (IgE)-mediated type I and T-cell-mediated type IV reactions. A typical type I reaction occurs immediately, within seconds to several minutes, but symptoms may appear in 1-4 hours. The type IV response is mediated by T cells exposed to antigens expressed by Langerhans cells, and the response occurs when sensitized memory T cells are re-exposed to the same antigens. It usually takes 24-72 hours, but can appear within 2 hours in some cases. The most dangerous are the allergic reactions occurring on the immunoglobulin E-dependent type, since anaphylactic shock, Quincke's edema, and urticaria most often develop in this case. In the case of a delayed T-cell reaction, antigens are recognized by sensitized T-lymphocytes, followed by the synthesis of lymphokines and the development of an inflammatory reaction. In this case, an allergy to local anesthetics is manifested by local swelling and allergic contact dermatitis.

In addition, cases of allergic reactions to preservatives included in the anesthetic, chlorhexidine and latex have been described.

This test determines the level of specific immunoglobulin E to a specific anesthetic. Please note that this test determines only the possible development of allergy according to 1 type of reaction, that is, hypersensitivity of the immediate type. In addition, it is necessary to remember that the production of specific immunoglobulins E occurs after the initial injection, but the clinical manifestation of allergic reactions occurs only with repeated injection (sensitization period)

Basic rules:

1. To take the analysis, you need to have a REFERRAL FROM THE DENTIST with the names of the anesthetics that need to be tested. WE DO NOT TAKE AN ANALYSIS without a referral from a dentist.
2. Taking blood does not require compliance with the rule "on an empty stomach".
3. If the results of the study showed a negative result for an anesthetic that the patient has never used in his life, then before re-introducing this drug, it is necessary to conduct a study again to rule out sensitization.
4. If in the patient's history there were cases of anaphylaxis or swelling during other invasive manipulations, then it is necessary to perform an analysis for tryptase or for the "Medical Allergy" package, which includes tryptase, latex, chlorhexidine and gelatin.