The need to make allergy tests for anesthetics (dental, any other used for medical purposes) can arise in the life of any person. If the body is prone to a hypersensitivity reaction, a simple and relatively inexpensive test will allow you to accurately determine if there are risks, which medications are safe for a person, and which are associated with an escalation of anaphylactic shock, angioedema, and other manifestations of the body’s hypersensitivity.
general information
An allergy to anesthetics is observed more often than to most of the medications known to mankind. To some extent, antibiotics can argue about the frequency of reactions with painkillers. The peculiarity of an allergic reaction to anesthetics, especially those used for local anesthesia, is in danger to the patient's life and systemic effects on the body. Let's consider everything in order.
It is customary to divide analgesics with a local effect and providing general anesthesia. Local efficacy is characteristic of para-aminobenzoic acid ester compounds, allocated in a separate category, and all other drugs combined in the second class. The first group includes drugs containing pro-, tetra-, benzo-, chloro-pro-, cyclomethicain. The second class is the Lidocaine anesthetic, as well as the common compounds: ultra-, mar-, brilu-, prilo-, pramo-, mepiva-, ethido-, bupivacaine. In the same category belong medicines based on zincoquine, diclonin.
Allergy features
As is known from a study of cases of anesthesia allergy, cross-allergic responses are inherent in the first category of drugs. These are occasionally found within the second category. Between these two classes, the probability of a cross-response is estimated to be zero.
As any doctor-allergist-immunologist will explain, the use of local anesthesia is always associated with an increased risk of an adverse reaction of the body. At the same time, anaphylactic reactions are observed in a small percentage of cases; local direct toxic effect is much more often recorded. The administration area of the drug swells, the patient's blood pressure decreases and the frequency and rhythm of the heartbeat is disturbed, possibly fainting. Such reactions may be allergic in nature or due to other mechanisms.
Opportunities and risks
As necessarily indicated in any instructions for use for Novocaine in ampoules, Lidocaine, any other medication used for pain relief in medical practice, if there is reason to assume intolerance to analgesics, their administration should be abandoned. There are cases when it is impossible to exclude the use of the drug. This is more often observed in dental practice. The only option is the replacement of local funds with systemic drugs, but those that cause complications are more likely.
Assuming an unwanted response from the body, it is reasonable to conduct a special test in advance. Allergists and immunologists draw attention to the lack of final official conclusions regarding the reliability of skin tests, and yet they mostly begin to establish the possibility of a reaction with just such measures. Having chosen a medicinal composition, it is used for a provocative test, skin. It is necessary to resort only to such a tool that does not have cross-effects with drugs that previously became the cause of the hypersensitivity reaction. In order to exclude a false negative test result, you need to make sure that there are no drugs in the medication that can narrow the vessels.
Efficient and reliable
According to the instructions for use developed by manufacturers of analgesics (“Ubistezin” in dentistry, other drugs in medical practice), immediately during treatment, one should resort to those drugs whose composition contains substances that constrict blood vessels. This helps to reduce unwanted systemic effects. In addition, sulfites, vasoconstrictor ingredients, very rarely provoke a hypersensitivity reaction. Adrenaline is often used as an additive.
Local analgesic agents used for skin testing should not include paraoxybenzoic acid esters. These substances provoke an allergic response with an increased degree of probability.
Anaphylactic response
It is known that the probability of such a reaction during anesthesia is estimated as one case per 5-15 thousand patients. Mortality is estimated at an average of 5%. More often, this result provokes the use of muscle relaxants, drugs for induction pain relief - all these drugs initiate the generation of histamine. It is known that more often the answer arises at the first use. If surgery is planned, it is necessary to determine whether there were any previous complications of anesthesia, which drugs were used. The patient will definitely have to do an allergy test for anesthetics.
It so happened that the very likelihood of an allergic reaction, which was previously known, but they spoke quite little, in recent years began to attract more and more public attention. This is noticeable not only in the practice of doctors who are forced to work with cases requiring general anesthesia. Allergies are increasingly common among dentist clients, and many clinics refuse to accept patients without a preliminary study.
Two sides of the same coin
Of course, resorting to popular drugs (for example, in dentistry - “Ubistezin”), the instructions for use, containing an indication of the possibility of an allergic response, must be observed very strictly, and the manufacturer always indicates the need to refuse the drug if the risk of allergies is assessed as high. On the other hand, the likelihood of a hypersensitivity reaction by some experts is estimated to be above average for all patients without exception, and dental care without analgesics today does not seem to be feasible. In some cases, this is due to the discomfort of the client, in others it is simply impossible to intervene without the use of pain medication.
Most often they are interested in where to do allergy tests, parents of young children. Since in recent years the issue has become especially relevant, the possibility of obtaining information is in any more or less large city. Samples are carried out by special laboratories. Such are more often open at large dental clinics or research, laboratory centers and services. The cost of one study varies between 300-1000 rubles, specific price tags are determined by the city and the pricing policy of the medical institution.
How it works?
It is far from always clear to the layman what allergy is, what it can occur to. Of course, everyone knows that in the accompanying documentation for any medication the manufacturer indicates that the product may provoke an answer indicating increased sensitivity, but from the same accompanying instructions for use in Novocain ampoules it is far from always clear how great the risks are business.
Professionals say that conducting samples is mandatory for everyone and constantly - a meaningless and thankless task. The reaction can occur unpredictably, on any substance used in medicine, including an allergy remedy. A negative result of a once organized test does not guarantee that in the future a person will not encounter a condition indicating increased sensitivity.
And what to do?
It happens that the doctor to whom the patient turned for help (more often this is observed in dentistry) insists on conducting an allergy skin test for anesthetics. Such an event is entirely in the field of responsibility of the allergist-immunologist. Professionals with a different specialization cannot make a test; they do not have this right.
If an immediate allergic reaction begins, the amount of allergen used does not matter. As a rule, allergy tests for anesthetics are done by people who are seriously afraid of anaphylactic shock. It must be remembered that even insignificant volumes of medications used for the study can escalate this response of the body.
Am I allergic?
It happens that a person needs planned treatment, while the measures involve pain relief, and the patient himself does not have the slightest idea about the possible allergic reactions inherent in his body. In allergology, a specific patient management protocol has been developed specifically for such cases. It begins with a survey, the formation of an anamnesis. At the same time, a person reports on substances previously introduced to him and the reaction to them or its absence, and can also say that some medication has never been used before. Any of these options does not require an allergy test for anesthetics. If the procedure provokes an undesirable effect, primary professional assistance is immediately provided to the person.
If previously anesthetics provoked a hypersensitivity reaction, the doctor should refer the client to an allergist. Only after additional research activities do they begin the planned treatment of the patient.
It hurts, I can’t!
It happens that a person comes to the dentist's office because of a strong, acute toothache. Even in this case, the doctor must first interview the client, only then choose drugs to provide assistance. If a person reports a previously observed allergic reaction, the doctor does not have the right to take it - it is necessary to redirect the patient to a hospital.
Some, fearing that they will be forced to do allergy tests for anesthetics or be sent to another department, hide that they previously suffered hypersensitivity reactions to painkillers. This strategy is fraught with risks, not just an unpleasant reaction, but a fatal outcome. Of course, in any clinic, doctors have everything at hand to help with anaphylactic shock, however, putting yourself in a vulnerable position is extremely unwise.
Where to go?
If a person consciously wants to undergo an allergy test for anesthetics, it is necessary to go to a clinic where qualified allergists and immunologists work. Such institutions are in any large settlement of our country. There are specialized offices in state clinics; You can get a referral to a doctor from your local GP. The duration of the test is about 30 minutes, the results are usually ready in a week. Samples are most often recommended for people who need long-term treatment with antimicrobial and painkillers.