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

Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001 Apr;91(4):402-5. doi: 10.1067/moe.2001.113348.

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.

Publication types

  • Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anesthetics, Local / adverse effects*
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Drug Hypersensitivity / diagnosis*
  • Drug Hypersensitivity / etiology
  • Female
  • Humans
  • Hypersensitivity, Immediate / chemically induced
  • Hypersensitivity, Immediate / diagnosis*
  • Immunoglobulin E / immunology
  • Male
  • Middle Aged
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Skin Tests / methods*

Substances

  • Anesthetics, Local
  • Immunoglobulin E