Journal of Dental Anesthesia and Pain Medicine

The Korean Dental Society of Anesthsiology (대한치과마취과학회)
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Allergic reactions to local anesthetic mepivacaine in dental procedures: a case report

  • Yoonhyoung Nam (Department of Advanced General Dentistry, College of Dentistry, Yonsei University) ;
  • Seyeon Min (Department of Advanced General Dentistry, College of Dentistry, Yonsei University) ;
  • Wonse Park (Department of Advanced General Dentistry, College of Dentistry, Yonsei University) ;
  • Kee-Deog Kim (Department of Advanced General Dentistry, College of Dentistry, Yonsei University)
  • Received : 2023.02.05
  • Accepted : 2023.05.22
  • Published : 2023.06.01
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Abstract

Local anesthetics are an essential part of pain control during dental treatment. Despite its effectiveness and safety, patients should constantly be aware of potential adverse effects, including allergic reactions. Allergic reactions to amide-type local anesthetics (LAs), such as lidocaine and mepivacaine, are rare compared to those to ester-type LAs. Herein, we report the case of a patient with a history of allergy to lidocaine and mepivacaine, with symptoms of itching, diffuse erythema of the wrists and hands, dizziness, and pectoralgia. This case report emphasizes the importance of collecting medical and dental histories of patients is necessary, and how an allergy test in the allergy and clinical immunology department helps select safe LAs for patients.

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References

  1. Covino BG. Physiology and pharmacology of local anesthetic agents. Anesth Prog 1981; 28: 98-104.
  2. Petrikas AZh, Ol'khovskaia EB, Medvedev DV, Diubaĭlo MV. Stomatologiia(Mosk) 2013; 92: 71-6.
  3. Budenz AW, Dugoni AA. Injection technique and local anesthetic agent selection. Tex Dent J 2011; 128: 110-2.
  4. Speca SJ, Boynes SG, Cuddy MA. Allergic reactions to local anesthetic formulations. Dent Clin North Am 2010; 54: 655-64. https://doi.org/10.1016/j.cden.2010.06.006
  5. Lee J, Lee JY, Kim HJ, Seo KS. Dental anesthesia for patients with allergic reactions to lidocaine: two case reports. J Dent Anesth Pain Med 2016; 16: 209-12. https://doi.org/10.17245/jdapm.2016.16.3.209
  6. Sharma V, Harper NJ, Garcez T, Arkwright PD. Allergic reaction to mepivacaine in a child. Br J Anaesth 2013; 110: 1059-60. https://doi.org/10.1093/bja/aet147
  7. Canfield DW, Gage TW. A guideline to local anesthetic allergy testing. Anesth Prog 1987; 34: 157-63.
  8. Dispenza MC. Classification of hypersensitivity reactions. Allergy Asthma Proc 2019; 40: 470-3. https://doi.org/10.2500/aap.2019.40.4274
  9. Finder RL, Moore PA. Adverse drug reactions to local anesthesia. Dent Clin North Am 2002; 46: 747-57. https://doi.org/10.1016/S0011-8532(02)00018-6
  10. Kaufman E, Jastak JT. Sedation for outpatient dental procedures. Compend Contin Educ Dent 1995; 16: 462, 464, 466 passim; quiz 480.
  11. Fuzier R, Lapeyre-Mestre M, Mertes PM, Nicolas JF, Benoit Y, Didier A, et al. Immediate- and delayed-type allergic reactions to amide local anesthetics: clinical features and skin testing. Pharmacoepidemiol Drug Saf 2009; 18: 595-601. https://doi.org/10.1002/pds.1758
  12. El-Qutob D, Morales C, Pelaez A. Allergic reaction caused by articaine. Allergol Immunopathol (Madr) 2005; 33: 115-6. https://doi.org/10.1157/13072924
  13. Bircher AJ, Messmer SL, Surber C, Rufli T. Delayed-type hypersensitivity to subcutaneous lidocaine with tolerance to articaine: confirmation by in vivo and in vitro tests. Contact Dermatitis 1996; 34: 387-9. https://doi.org/10.1111/j.1600-0536.1996.tb02238.x
  14. Duque S, Fernandez L. Delayed-type hypersensitivity to amide local anesthetics. Allergol Immunopathol(Madr) 2004; 32: 233-4. https://doi.org/10.1016/S0301-0546(04)79245-9