No cases of perioperative allergy to local anaesthetics in the Danish Anaesthesia Allergy Centre

A D Kvisselgaard; M Krøigaard; H F Mosbech; L H Garvey

doi:10.1111/aas.12833

No cases of perioperative allergy to local anaesthetics in the Danish Anaesthesia Allergy Centre

A D Kvisselgaard, M Krøigaard, H F Mosbech, L H Garvey

Department of Clinical Medicine

18 Citations (Scopus)

Abstract

BACKGROUND: Local anaesthetics (LA) are often suspected as possible causes of allergic reactions. The Danish Anaesthesia Allergy Centre (DAAC) is the national reference centre for investigation of perioperative allergic reactions. The purpose of this study was to investigate the incidence of IgE-mediated immediate type perioperative allergic reactions to LA.

METHODS: In the period 2004-2013, a total of 409 patients (244 women/165 men; median age 49 years, range 1-86 years) were investigated in DAAC on suspicion of allergy associated with anaesthesia and surgery. A total of 162 (40%) patients were exposed to one or more LA. Suspected allergy to LA was investigated by prick test, intradermal test and subcutaneous provocation with the suspected drug. Patients with positive skin tests still underwent subcutaneous provocation, as false positive skin tests can occur.

RESULTS: A total of 203 test series with LA were carried out on 162 patients (89 women/73 men; mean age 49 years, range 2-85 years) with the following drugs: Lidocaine n = 80 (49%), bupivacaine n = 82 (51%), ropivacaine n = 31 (19%) and mepivacaine n = 10 (6%). All 162 patients had negative subcutaneous provocation for all tested LA (95% CI: 0-1.8%). Investigations revealed another allergen in 52 of 162 patients.

CONCLUSION: None of the 162 patients with suspected perioperative allergic reactions and exposure to LA reacted on subcutaneous provocation with the relevant LA. Thus, no patients have been diagnosed with allergy to LA in DAAC in the period 2004-2013 and allergy to LA must be considered very rare in this population.

Original language	English
Journal	Acta Anaesthesiologica Scandinavica
Volume	61
Issue number	2
Pages (from-to)	149-155
ISSN	0001-5172
DOIs	https://doi.org/10.1111/aas.12833
Publication status	Published - 1 Feb 2017

Keywords

Adolescent
Adult
Aged
Aged, 80 and over
Anesthetics, Local/adverse effects
Child
Child, Preschool
Drug Hypersensitivity/epidemiology
Female
Humans
Male
Middle Aged

Access to Document

10.1111/aas.12833

Cite this

@article{1f33fb7d6906404780dc75065777b193,

title = "No cases of perioperative allergy to local anaesthetics in the Danish Anaesthesia Allergy Centre",

abstract = "BACKGROUND: Local anaesthetics (LA) are often suspected as possible causes of allergic reactions. The Danish Anaesthesia Allergy Centre (DAAC) is the national reference centre for investigation of perioperative allergic reactions. The purpose of this study was to investigate the incidence of IgE-mediated immediate type perioperative allergic reactions to LA.METHODS: In the period 2004-2013, a total of 409 patients (244 women/165 men; median age 49 years, range 1-86 years) were investigated in DAAC on suspicion of allergy associated with anaesthesia and surgery. A total of 162 (40%) patients were exposed to one or more LA. Suspected allergy to LA was investigated by prick test, intradermal test and subcutaneous provocation with the suspected drug. Patients with positive skin tests still underwent subcutaneous provocation, as false positive skin tests can occur.RESULTS: A total of 203 test series with LA were carried out on 162 patients (89 women/73 men; mean age 49 years, range 2-85 years) with the following drugs: Lidocaine n = 80 (49%), bupivacaine n = 82 (51%), ropivacaine n = 31 (19%) and mepivacaine n = 10 (6%). All 162 patients had negative subcutaneous provocation for all tested LA (95% CI: 0-1.8%). Investigations revealed another allergen in 52 of 162 patients.CONCLUSION: None of the 162 patients with suspected perioperative allergic reactions and exposure to LA reacted on subcutaneous provocation with the relevant LA. Thus, no patients have been diagnosed with allergy to LA in DAAC in the period 2004-2013 and allergy to LA must be considered very rare in this population.",

keywords = "Adolescent, Adult, Aged, Aged, 80 and over, Anesthetics, Local/adverse effects, Child, Child, Preschool, Drug Hypersensitivity/epidemiology, Female, Humans, Male, Middle Aged",

author = "Kvisselgaard, {A D} and M Kr{\o}igaard and Mosbech, {H F} and Garvey, {L H}",

note = "{\textcopyright} 2016 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.",

year = "2017",

month = feb,

day = "1",

doi = "10.1111/aas.12833",

language = "English",

volume = "61",

pages = "149--155",

journal = "Acta Anaesthesiologica Scandinavica",

issn = "0001-5172",

publisher = "Wiley-Blackwell",

number = "2",

}

TY - JOUR

T1 - No cases of perioperative allergy to local anaesthetics in the Danish Anaesthesia Allergy Centre

AU - Kvisselgaard, A D

AU - Krøigaard, M

AU - Mosbech, H F

AU - Garvey, L H

PY - 2017/2/1

Y1 - 2017/2/1

N2 - BACKGROUND: Local anaesthetics (LA) are often suspected as possible causes of allergic reactions. The Danish Anaesthesia Allergy Centre (DAAC) is the national reference centre for investigation of perioperative allergic reactions. The purpose of this study was to investigate the incidence of IgE-mediated immediate type perioperative allergic reactions to LA.METHODS: In the period 2004-2013, a total of 409 patients (244 women/165 men; median age 49 years, range 1-86 years) were investigated in DAAC on suspicion of allergy associated with anaesthesia and surgery. A total of 162 (40%) patients were exposed to one or more LA. Suspected allergy to LA was investigated by prick test, intradermal test and subcutaneous provocation with the suspected drug. Patients with positive skin tests still underwent subcutaneous provocation, as false positive skin tests can occur.RESULTS: A total of 203 test series with LA were carried out on 162 patients (89 women/73 men; mean age 49 years, range 2-85 years) with the following drugs: Lidocaine n = 80 (49%), bupivacaine n = 82 (51%), ropivacaine n = 31 (19%) and mepivacaine n = 10 (6%). All 162 patients had negative subcutaneous provocation for all tested LA (95% CI: 0-1.8%). Investigations revealed another allergen in 52 of 162 patients.CONCLUSION: None of the 162 patients with suspected perioperative allergic reactions and exposure to LA reacted on subcutaneous provocation with the relevant LA. Thus, no patients have been diagnosed with allergy to LA in DAAC in the period 2004-2013 and allergy to LA must be considered very rare in this population.

AB - BACKGROUND: Local anaesthetics (LA) are often suspected as possible causes of allergic reactions. The Danish Anaesthesia Allergy Centre (DAAC) is the national reference centre for investigation of perioperative allergic reactions. The purpose of this study was to investigate the incidence of IgE-mediated immediate type perioperative allergic reactions to LA.METHODS: In the period 2004-2013, a total of 409 patients (244 women/165 men; median age 49 years, range 1-86 years) were investigated in DAAC on suspicion of allergy associated with anaesthesia and surgery. A total of 162 (40%) patients were exposed to one or more LA. Suspected allergy to LA was investigated by prick test, intradermal test and subcutaneous provocation with the suspected drug. Patients with positive skin tests still underwent subcutaneous provocation, as false positive skin tests can occur.RESULTS: A total of 203 test series with LA were carried out on 162 patients (89 women/73 men; mean age 49 years, range 2-85 years) with the following drugs: Lidocaine n = 80 (49%), bupivacaine n = 82 (51%), ropivacaine n = 31 (19%) and mepivacaine n = 10 (6%). All 162 patients had negative subcutaneous provocation for all tested LA (95% CI: 0-1.8%). Investigations revealed another allergen in 52 of 162 patients.CONCLUSION: None of the 162 patients with suspected perioperative allergic reactions and exposure to LA reacted on subcutaneous provocation with the relevant LA. Thus, no patients have been diagnosed with allergy to LA in DAAC in the period 2004-2013 and allergy to LA must be considered very rare in this population.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Anesthetics, Local/adverse effects

KW - Child

KW - Child, Preschool

KW - Drug Hypersensitivity/epidemiology

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

U2 - 10.1111/aas.12833

DO - 10.1111/aas.12833

M3 - Journal article

C2 - 27878813

SN - 0001-5172

VL - 61

SP - 149

EP - 155

JO - Acta Anaesthesiologica Scandinavica

JF - Acta Anaesthesiologica Scandinavica

IS - 2

ER -

No cases of perioperative allergy to local anaesthetics in the Danish Anaesthesia Allergy Centre

Abstract

Keywords

Access to Document

Fingerprint

Cite this