Allergic rhinitis and general anesthesia is it possible. Allergy as a reaction of the body to the introduction of anesthesia. What can be used to treat this reaction

Anesthesia was one of the major medical discoveries of the twentieth century. With her help, it became possible to carry out painless surgical interventions. But there are times when a patient develops an allergy to anesthesia. It is associated with individual intolerance by the patient's body of a certain pharmacological drug.

The doctor finds out the patient's allergic history

Regardless of which anesthesia was used, the list of allergic reactions is the same. Below are the types of allergic manifestations characteristic of anesthesia:

If a person knows that he is allergic to any drug, or has ever had such allergic reactions, he should always carry a piece of paper with him where it is written. No one is safe from unforeseen situations, and such a memo will tell the doctor what to do and what medicines not to use.

Allergy to general anesthesia

General anesthesia, or general anesthesia, is a state of drug-induced sleep. The patient is given a series of medications that turn off the patient's consciousness for a while, relax his muscles, making him insensitive to medical manipulations. It is used in surgery for major operations. In children, it is sometimes used in dentistry in the treatment of teeth. A person falls asleep after the introduction of medications, or after inhalation of special substances.

Allergy to anesthesia is dangerous by the speed of development. Conducting general anesthesia, doctors are afraid, first of all, of anaphylactic shock. All operating rooms have first aid kits in case of emergency.

The anesthesiologist is ready to help the patient at any time

spinal anesthesia

Epidural anesthesia is a method of pain relief during which an anesthetic is injected into the spine, or rather, into the epidural space of the spine. It is used during childbirth, caesarean section. After it, there are much fewer complications. Gynecologists, performing various operations on the pelvic organs, give preference to anesthesia in the spine. This method of anesthesia is widely used in traumatology, during surgical interventions on the legs and pelvis.

An analgesic substance is injected into the spine, and after that the patient, remaining conscious, does not feel anything below the level of the waist.

Administration of epidural anesthesia

Local anesthesia

This method is used by a doctor when it is required to completely anesthetize an area of ​​skin or mucous membrane for a short time. Most often it is used in dentistry for the treatment or extraction of teeth. In surgery, it is used for opening panaritium, phlegmon, stitching wounds on the skin.

After the injection of the drug, the patient feels numbness. Usually, it passes in an hour. This time is enough for the doctor to carry out all the manipulations.

Allergy to local anesthesia develops quite often. In this regard, before administering the drug, the doctor must conduct a test. He injects a tiny amount of anesthetic under the skin. If the patient has intolerance to this drug, redness, itching and swelling appear. In this case, the use of this substance is strictly contraindicated!

Although there are cases that after a negative allergy test, the patient developed anaphylactic shock during dental treatment or wound closure. Knowing this, dentists and surgeons always have an ampoule of Adrenaline and Prednisolone in their office, because when such a reaction begins, there is no time to wait for an ambulance.

Adrenaline is used for emergency treatment of anaphylaxis

Allergic reactions can occur to any type of anesthesia. The doctor must always be prepared for such a complication, and have all the necessary drugs for first aid. Patients, in turn, must remember which drugs they have an allergic reaction to, and inform the treating doctor about this.

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Question: I'm due for a colonoscopy as part of an examination ordered by my GP due to low hemoglobin. Two years ago, the same doctor diagnosed IBS. I would like to know if it is possible to have no sleep during sedation or interrupt it during the examination and is it still possible to feel pain despite anesthesia? I don't handle pain well. These questions arise out of ignorance; never made such a survey. And how to check allergic reactions to anesthesia? What would you recommend as an anesthetic in my situation, midazolam or propofol or something else? Thanks in advance.

Answer: Hello. Let's start with allergies. Checking for possible allergic reactions to anesthesia is carried out only in two cases - the presence of an allergy to anesthesia in the past or the presence of a polyvalent drug allergy. To conduct research (which can be performed in various ways - from a blood test from a vein to special skin tests), it is necessary to know the type of anesthetic drugs that will be used during anesthesia. That is, performing allergy tests requires, at a minimum, prior consultation with an anesthesiologist. Why aren't allergy tests done on all patients? Firstly, the likelihood of severe allergies is actually very low (1 case in 10-15 thousand anesthesias). Secondly, there are no such allergological studies that could give a 100% guarantee for the presence / absence of allergies. Thirdly, in itself, the performance of some studies (in particular, skin tests) can act as a provoking factor for the development of allergies during planned anesthesia. Therefore, if you did not have an early allergy to anesthesia, then there is no point in performing any research.

To answer the "second" part of the question, you need to know what kind of anesthesia is planned - sedation or anesthesia? Sedation causes either a feeling of calm or sleep, while it does not block pain sensations, although it often erases memories of the procedure in memory (it seems to the patient that everything went without pain, although pain sensations could still be present). Therefore, sedation is performed either during procedures that are not accompanied by severe pain (for example, gastroscopy), or in combination with local anesthesia (for example, dental treatment). Narcosis, on the other hand, causes deep sleep in combination with a complete blockade of pain perception, that is, during anesthesia, the patient is always asleep and does not feel anything.

As for drugs, in the case of sedation, both propofol and midazolam are suitable. For anesthesia, the use of propofol is optimal. All the best!

Question: Hello! I had 2 surgeries under general anesthesia. And twice I heard that in intensive care after the operation I could not wake up myself. After the second operation, the anesthesiologist himself was sitting next to me when I woke up and looked at me with frightened eyes, after which he said that it was good that I did not see myself at that moment. According to him, he could not bring me to my senses and I did not come to my senses for 3 hours. In addition, both times my lips turned black. I recently had a menopausal scraping. Since I am allergic to lidocaine, I was given general anesthesia. And they also woke up for a long time. Already at home on the 4th day, I noticed blackness in the corners of the lips, which gradually disappeared. That's why I'm very afraid of anesthesia. Please tell me what is the cause of this condition? I will be very grateful to you for your answer.

Answer: Good evening. There are probably at least 20 reasons that can lead to delayed awakening from anesthesia, ranging from the development of serious diseases (impaired cerebral circulation), ending with such a rare hereditary pathology as pseudocholinesterase deficiency (a blood enzyme that destroys muscle relaxants - one of the components of anesthesia) . What was the leading cause specifically in your case can only be said after you have personally performed anesthesia, that is, you need to “see” everything with your own eyes (take tests, etc.). Therefore, only the anesthesiologist who performed anesthesia can give a more or less intelligible answer to your question. In any case, what happened to you is not a serious problem (since you were awakened and you did not lie in intensive care for a long time), that is, it will in no way affect your current state of health and, if repeated in the future, will not lead to any adverse consequences. Therefore, forget about what happened, return to normal life and do not worry. All the best!

Question: Good afternoon! Tell me, can a child be 2 years 4 months old. before general anesthesia to remove adenoids on a trip to the hospital to give Dramina?

Answer: Hello. Yes, there are no contraindications to taking dramin, moreover, this drug has a number of beneficial effects, such as sedative (calming) and antiemetic, which will be very useful before planning general anesthesia. I wish you a successful operation!

Question: I am 56 years old. hyperplasia of the endometrium. Assigned to the WFD. Concomitant diseases: hypertension, IRR of the hypertensive type, hypothyroidism, osteochondrosis, varicose veins of the lower extremities, cholecystitis. What kind of more gentle anesthesia can I be prescribed? And how does it work? Thank you!

Answer: Hello. Given the nature of the existing comorbidities, the most optimal would be the use of propofol (+/- fentanyl) for anesthesia, the worst option would be the use of ketamine,. It is important that the usual level of blood pressure (the so-called "working pressure") be no more than 160/90, otherwise hypertension should be treated first (which requires more than one week), and only then the uterine cavity should be scraped. An important point is the prevention of blood clots in the veins of the legs, for which on the morning of the operation, without getting out of bed, you will need to put on pre-purchased compression stockings or bandage your legs with elastic bandages.

All the best!

Question: Hello! My child is 1 year 9 months old. On March 26, we underwent an operation to remove an inguinal hernia on the right side and umbilical. The child was in the operating room for 1 hour and 30 minutes. The operation was performed by laparoscopy. When they brought the baby, I must admit that his face was not on it ... the expression on my child's face spoke of something that had happened. His eyes parted in different directions, his chin was pubescent, he did not react to my hand with a glance, he only cried a little, and calmed down only when I took him in my arms. In this state after anesthesia, he stayed for 2 hours. When I asked what happened to the child and why the operation took so long, the answer was "THIS HAPPENED". Then, by long pressure on the doctors, I managed to extract at least some explanation from them. I was told that the anesthesiologist didn't like the breathing...then they couldn't wake your child up...and in general he didn't take the anesthesia very well. That's all they answered me. On Monday we'll go to the hospital to remove the stitches... and I'll talk again. But I wanted to understand a little bit what might have happened. I was very scared for my baby. I believe that if my child, in its physiological structure, does not tolerate anesthesia well, then any self-respecting anesthesiologist will always tell you what and why. And what should be kept in mind for the future... In this situation, it seems to me that some mistake was made... which of course no one will tell me about. I will add that anesthesia was a general mask plus a tube into the trachea, as I understand it. I will very much look forward to your answer. Thanks in advance. Ps I have an idea how both adults and children wake up from anesthesia ... but the way my child woke up, I'm sure something was wrong.

Answer: Hello. The described condition of the child fits into the so-called delayed post-anesthetic awakening (post-anesthetic depression), which could be caused by the use of anesthetic drugs with a long period of action, impaired oxygen delivery to the brain during anesthesia (due to acute respiratory or heart failure), a decrease in blood glucose, etc. That is, there are actually a lot of possible reasons (for example, in the manuals on anesthesiology, a whole separate chapter is devoted to this topic), therefore, only the anesthesiologist who performed anesthesia (not even surgeons, since they poorly versed in our specialty). Now it is important to know how the child feels. If his condition corresponds to the preoperative one, then you should not worry, if any complications happened, then it has passed and will never make itself felt in the future. If there are any violations, then it is important to be examined by a pediatrician and eliminate the problem. In general, I think that everything should be fine, because if something very serious happens, the child is never given to the parents, but transferred to the intensive care unit for close post-anesthesia monitoring and treatment. I wish your baby a speedy recovery and good health!

Question: Hello!!! My son is 2 years and 3 months old. We go to the hospital on Monday to remove a dermoid cyst on the outer part of the eyebrow and dropsy. Tell me what kind of anesthesia we will do or what kind of anesthesia to ask the anesthesiologist. What are the consequences after anesthesia in children and is it dangerous at all ??? Thanks in advance!

Answer: Good evening. In fact, it is not so important what kind of anesthesia is carried out, what anesthetic drugs are used, etc., how this anesthesia is carried out is much more significant. In order to conduct anesthesia safely for the health of the patient, you must be a professional in your field. Therefore, it is best to concentrate all your efforts not on asking the anesthesiologist to perform a good anesthesia, and not on finding that very good (competent, experienced, etc.) anesthesiologist. A good anesthesiologist is the key to good anesthesia. Regarding the dangers and consequences of anesthesia, read the answer (plus links) to the previous patient. I wish your child a successful operation and anesthesia!

Question: Hello. Daughter cavernous hemangioma, she is 4 months old, decided to have an operation, please tell me what kind of anesthesia, and is it dangerous at such an early age? Is it possible to do anesthesia with dermatitis? The dermatologist told us to treat first. Thanks in advance for your reply.

Answer: Good evening. If the dermatitis does not affect the area of ​​operation and is non-allergic in nature, then there are no contraindications to anesthesia. Otherwise (especially during an exacerbation of an allergy), of course, it is first necessary to be treated, and only then go for an operation. Whether anesthesia is dangerous or not is a philosophical question (for more details, see Is anesthesia harmful?). Yes, anesthesia can cause serious complications, but in the vast majority of cases it has a favorable outcome. After all, the meaning of surgical treatment is to help the patient to radiate from the disease, respectively, the benefits expected from the operation and anesthesia many times exceed the possible harm. In general, a good outcome of anesthesia is largely determined by the professional qualities of an anesthetist (see what is good anesthesia), so if you make sure that anesthesia is performed by a good specialist, then everything will go well. What else? If anesthesia can be avoided, then it is better to refuse it. In terms of hemangioma (if it is small), a good alternative to surgical excision (or coagulation) may be laser removal, which does not require anesthesia. All the best!

An allergic reaction in response to the drug used for anesthesia occurs very quickly - instantly, during the first 10-15 minutes, after an hour and even after a day. The form of such a reaction may be different, but the most severe is considered anaphylactic shock. All honey. institutions are equipped to provide successful first aid for this complication.

General principles for the development of drug allergy

Speaking of allergies to, it should be noted that as a result of its initial intake, sensitization is activated. Therefore, the accepted substance turns into. Repeated intake is associated with the activation of mast cells that direct histamine into the blood. The result is irritation of the nerve endings, muscle and vascular spasms, mucus production and capillary expansion. Therefore, allergy symptoms are often itching, rash, swelling and anaphylaxis discussed above.

At the same time, there is also an immune-type reaction that manifests itself delayed. Leukocytes are sent to the zone of inflammatory changes, and connective tissue is formed in the place of the affected cells. The result is the development of complications in the form of dangerous pathologies. These include thrombocytopenia, hemolytic anemia, vasculitis, and serum sickness.

Features of allergy to anesthesia

Anesthesia is a special group of drugs that allow you to reduce the sensitivity of the whole body or its individual parts. Under their action, nerve impulses stop passing, which is necessary for the operation. Anesthesia can be of two types:

1. General when the sensitivity of a person is completely eliminated, as he is transferred to an unconscious state. Allocate simple and combined anesthesia. It can be carried out by inhalation or by injecting a substance into a vein. This is a more difficult type of anesthesia for the patient, which requires preliminary preparation and examination.
2. local loss of sensation in a part of the body for a certain period of time. The conduction of individual nerves is turned off, but breathing and consciousness remain. The local type of anesthesia is more easily tolerated by patients, and there is no need for additional preparation. Usually used for operations of low complexity.

Local anesthesia can be:

• terminal or superficial, when for pain relief the drug is applied to the skin or mucous membrane from the outside;
• infiltration - subcutaneous injection of anesthetic;
• regional with the receipt of the drug in areas close in location to the nerve trunk (conduction, spinal, epidural, intravascular, intraosseous anesthesia).

For general anesthesia, doctors can use Fluorotan, Methoxyflurane, Hexenal, Ketamine, Etomidat, and for local anesthesia, Benzocaine, Prilocaine. It is important to remember that an allergic reaction is provoked not only by the main active ingredient, but also by auxiliary elements. Allergies can be caused by adrenaline, stabilizers, preservatives or parabens.

• the presence of previously occurring allergic manifestations in the anamnesis;
• pathological deviations in the functioning of the endocrine system;
• susceptibility to bronchial asthma or diabetes;
• genetic predisposition;
• frequent contact with substances of a chemical nature.

If the drug is administered very quickly, used on an empty stomach, after serious illnesses, in combination with other medications, the likelihood of allergies will increase significantly.

Symptoms

The reaction to anesthesia can be different in terms of the speed of manifestation - it can develop within 15 minutes, an hour after the manipulation, or 12-24 hours later. When the manifestation is observed instantly, doctors can quickly provide qualified assistance and reduce the risks of complications.

If the response of the body followed after a day or a little less, then people do not always associate the symptoms with anesthesia, but try to concentrate on other reasons. This is fraught with improper self-treatment, loss of time, which leads to negative consequences.

An allergy to general anesthesia in an adult or a child has similar forms of manifestation:

• development ;
• active spread of edema in the larynx;
• respiratory depression;
• problems with the work of the heart, up to its stop;
• a sharp drop in blood pressure.

When these signs appear, the condition should be assessed as quickly as possible and the patient should be provided with adequate medical assistance.

Local anesthesia can also provoke severe consequences up to anaphylactic shock. Such risks most often accompany anesthesia, although this type of reaction is also inherent in Benzocaine. The most common manifestations are:

• redness, soreness and swelling of tissues in the area of ​​contact with the drug;
• urticaria and the formation of vesicles on the skin;
• the formation of small red dots on the skin, which are localized in the area of ​​\u200b\u200bfolds or joints;
• feeling of itching;
• type and increased lacrimation;
• soreness of the epigastric type;
• nausea with vomiting;
• diarrhea of ​​varying intensity;
• pain in the head with the risk of loss of consciousness;
• angioneurotic edema.

To avoid death, resuscitation should begin on time!

It is important to remember the fact that sometimes the symptoms are not the result of the reaction to the drug itself, but are determined by the weakness of the body or non-compliance with the dosage. In particular, this is typical for intravenous general anesthesia, since its individual elements are toxic in nature and can adversely affect the functioning of the heart and respiratory system.

If the patient has diseases of the heart, kidneys, there are ailments in a chronic form, then the use of anesthesia is fraught with many risks. In this case, it is recommended to give preference to local anesthesia with careful selection of the agent and dosage, as well as with the control of the condition by a specialist.

Risk of complications

In some cases, anesthesia for allergies can provoke a number of complications. At the same time, it is very difficult to determine the change in state, since the person is unconscious or has limited sensitivity. Allergies in severe cases can provoke:

• inhibition of respiratory activity and heartbeats;
• changes in blood coagulation parameters, which is dangerous during surgery;
• deviations in the work of human organs and systems, which can be critical for life.

The consequences are manifested with a delay in the form of thrombocytopenia, hemorrhagic diathesis, serum sickness. In severe cases, complications lead to disability and even death of the patient.

Diagnostic procedure

If anesthesia has not been previously used to treat the patient or another drug has been used, then the allergy will be known at the time the first signs appear. Therefore, if you are prone to allergic reactions, you should think over the treatment tactics with your doctor in advance. It will not be superfluous to consult with an allergist or immunologist, who, to check for allergies, carry out:

1. Blood sampling for analysis of the enzyme immunoassay type, which will determine the presence in the plasma of antibodies of a specific type to proteins.
2. Measurements of the level of histamine in the blood.
3. Skin test samples. During testing, small incisions are made in the forearm area, into which a solution with a possible allergen is dripped. If swelling or redness occurs, it is concluded that there is a tendency to react to this substance.

Help with allergies

Treatment for an allergic reaction to anesthesia can be carried out urgently and electively. If manifestations of a systemic nature develop, then it is necessary to carry out resuscitation in the order of urgent assistance:

1. A tourniquet is applied over the site where the anesthetic was injected.
2. Adrenaline and Eufillin are injected. They normalize cardiac and pulmonary activity.
3. To relieve inflammation, prednisolone is administered.
4. As soon as the condition has stabilized, the patient takes a remedy, for example, Diphenhydramine, Suprastin, Loratadin, etc. Detoxifying agents are also used.

In the order of planned therapy for an allergic reaction, if the violation is mild, the symptoms are relieved and possible complications are prevented. Treatment is carried out with the help of such drugs:

1. remedies will help relieve symptoms and alleviate the condition. Doctors recommend using Zodak, Zirtek, Erius, Diazolin.
2. Enterosorbents relieve the load on the gastrointestinal tract system in the presence of digestive reactions - they take Polysorb or Filtrum.
3. To eliminate the manifestations, you can also use local means of influence - Fenistil Gel, Allergodil, Vizin Alerji.

Prevention

To prevent a possible allergy to the anesthetic, it is necessary to first pass a test for a tendency to reactions regarding the action. This will help identify intolerance to a particular. In this case, the doctor selects another drug that has not been identified as an allergy. In addition, the type of anesthesia can also be changed, for example, instead of local anesthesia, general anesthesia is performed and vice versa.

Anesthesia helps to alleviate the patient's condition during surgical and other medical procedures. However, it itself can be dangerous in the form of an allergic reaction. Such cases occur relatively infrequently, but are not completely excluded. Therefore, before conducting anesthesia, it is imperative to inform the doctor about possible sensitivity to the drug.

The dentist is the worst doctor ever. Of course, this is a joke statement, but not only children are afraid of a visit to the dentist - even adults find it difficult to cope with panic. Self-control comes to the rescue, sometimes sedative pills are required - the practice of using it before filling has long become routine. However, the best way to relax in your chair and let the doctor do his job is with an anesthetic injection, that is, a drug that blocks pain for a while. The person who applied for medical help does not feel anything in the area of ​​intervention - and the specialist freely carries out all the necessary manipulations. Of course, this greatly simplifies the situation for both the doctor and the patient - however, an allergy to anesthesia in dentistry can interfere with the use of anesthesia techniques. Unfortunately, it is not so rare - and can lead to a variety of consequences: from a skin rash to anaphylactic shock.

The reasons

Sensitivity to anesthetics used at the dentist's office is a type of drug intolerance. It may be related:

• with the development of special specific immune antibodies (sensitization);
• with pseudo-allergic reaction;
• with drug overdose.

The risk of developing symptoms increases:

1. With rapid administration of the drug.
2. When using an anesthetic on an empty stomach.
3. In the case of treating a person exhausted by a long illness.

Sensitization is characteristic of the so-called true allergy, while the false one proceeds without the participation of antibodies. The symptoms are the same, so it is not possible to distinguish them without special tests. The likelihood of developing sensitivity is higher in people who have already experienced an episode of drug intolerance, suffering from bronchial asthma, atopic dermatitis, or receiving many pharmacological drugs at the same time - they are able to enhance each other's allergenic potential.

In some people, sensitivity is due to a reaction not to the anesthetic itself, but to additional components:

• Adrenaline (Epinephrine);
• preservatives;
• antioxidants;
• stabilizers (sulfite, EDTA);
• bacteriostatic additives (parabens);
• latex as part of an ampoule with medicine.

A true allergic reaction to the anesthetic develops only after repeated administration of the drug.

The immune system needs time to develop antibodies, so the occurrence of violations during the initial use of the active substance means either the presence of sensitization in the past, or pseudo-allergy or overdose. This principle works with all drugs and methods of anesthesia (including if an epidural is planned). However, there is a nuance: when the patient is already sensitive to a certain pharmacological agent, and it has a similar antigenic structure with the drug administered for the first time, a true allergy can still develop immediately.

Symptoms

Reactions to anesthetics in dental practice can be:

• immediate (reaginic type);
• delayed.

According to statistical studies, most episodes of manifestations of sensitivity are recorded, on average, an hour or two after medical intervention. This allows you to quickly identify and prevent unwanted reactions in the future, as well as to conduct differential diagnostics with similar conditions. However, at the same time, delayed forms are not uncommon, manifesting 12 hours or more after the injection of the anesthetic.

Local (local) signs

1. Edema.
2. Redness (hyperemia).
3. Feeling of fullness, pressure.
4. Soreness of the gums, tooth - when biting.

The described signs are not dangerous in themselves, but they can develop along with other pathological reactions - urticaria, Quincke's edema. If the clinical picture includes only local symptoms, their relief (cessation) occurs even without treatment after a few days - of course, provided that the anesthetic that caused the development of disorders is not re-introduced.

Dermatological manifestations

This group includes all types of skin lesions associated with allergic intolerance to local anesthetics in dentistry. They develop in both immediate and delayed types, are not life-threatening or pose a very significant threat.

Hives

It is characterized by the following complex of manifestations:

• skin redness;
• swelling, severe itching;
• the occurrence of a rash in the form of blisters;
• general weakness;
• headache;
• increase in body temperature.

Sometimes there is also a decrease in blood pressure (hypotension). The blisters are small or large (up to 10-15 cm in diameter), pink, merge with each other. The fever is called "urticaria", thermometry values ​​range from 37.1 to 39 ° C. The rash disappears on its own, may persist for up to 24 hours; recurrence after the initial relief of symptoms is not ruled out.

This is an allergic reaction, which is often observed in combination with urticaria; in the process of development, different areas of the skin, loose fiber are affected. Localized mainly in the area:

1. Eye, nose, lips, cheeks.
2. Oral cavity.
3. Larynx, bronchi.

The swelling is formed quite quickly, grows within a few hours, has an elastic texture, rises above the level of the skin. The most dangerous location is in the respiratory tract (in particular, in the larynx) - it threatens with suffocation and, if timely assistance is not provided, with a fatal outcome. The clinic includes symptoms such as:

• significant swelling of the lips;
• pallor of the skin;
• difficulty breathing, which gradually increases;
• "barking" cough;
• dyspnea.

If the gastrointestinal tract is affected, it appears:

• nausea;
• vomit;
• abdominal pain;
• diarrhea.

If the localization of the edema is not life-threatening, it can stop on its own after 10-12 hours. Otherwise, the patient requires emergency medical attention to restore airway patency.

This is the most severe consequence of a reaction to a dental anesthetic and has the following symptoms:

1. Weakness.
2. Dizziness.
3. Tingling and itching of the skin.
4. Urticaria, angioedema.
5. Nausea, vomiting.
6. Difficulty breathing.
7. Sharp pain in the abdomen.
8. Seizures.

The development of anaphylactic shock is not determined by the dosage of the drug - even the minimum amount can provoke symptoms.

There are several forms of pathology, all of them are characterized by a sharp drop in blood pressure and hypoxia (oxygen starvation) of the body due to circulatory disorders. Occur at different times: from a few seconds to 2-4 hours after the administration of the drug.

Allergy to pain medication can also cause symptoms of rhinitis (runny nose), conjunctivitis (lacrimation, redness and swelling of the eyelids), isolated itching of the skin, not accompanied by rashes. Without treatment, pathological signs persist for several days, gradually weakening.

How do you know if you are allergic to anesthesia?

The reaction is caused by the interaction of a drug substance with immune antibodies of the IgE class. Their detection underlies most diagnostic tests, but history taking is primarily used. This is a patient survey to assess the nature of the symptoms and the likelihood of their being associated with an allergic intolerance.

Laboratory methods

Their use is widely practiced by dentists around the world to predict the response to anesthetics, filling materials and other components used in the treatment process. However, a positive test result is not yet a diagnosis; the judgment about the presence of an allergy should be supported by other information (for example, an anamnesis - objective manifestations observed after an injection of the drug in the past).

The most commonly used:

• complete blood count (increase in the number of eosinophil cells);
• enzyme immunoassay, chemiluminescent method for the detection of specific antibodies;
• determination of the level of tryptase, histamine;
• basophil activation test.

All methods have a different level and time period of sensitivity. Thus, tryptase levels can be determined on the eve of dental intervention (in order to assess the likely risk) or within a day from the moment symptoms manifest (maximum values ​​in anaphylaxis are observed after 3 hours, and the increase begins after 15 minutes). The search for antibodies is most often recommended to be performed within 6 months after the implementation of an allergic reaction.

Recognized as the safest skin test in determining the likelihood of sensitivity to local anesthetics in dentistry. Conducted using:

1. Compact lancets.
2. Allergen substances.
3. Diluting liquid.
4. Control drugs (negative, positive).

A solution of the test substance is applied to the skin (usually the forearm). Next - control suspensions. There are notes everywhere. The selected site is then pierced with a lancet, which, when used correctly, does not affect the blood vessels, but ensures rapid absorption of the drugs (and a high level of safety for the patient). Within a given time, the reaction is monitored - redness, swelling, blistering indicate a positive result (sensitivity).

Treatment

It is carried out as an emergency (in the dentist's office, on the street or at home after the development of symptoms) or planned (assigned by a doctor to eliminate manifestations that are not life-threatening, but cause discomfort).

Restriction on the use of an allergen drug

This method is also called elimination. The patient must refuse the anesthetic that caused the deterioration and, if necessary, undergo diagnostics to determine the immunological nature of the reaction. If it is confirmed, the use of a provocative drug in any form should be excluded - while it is important to pay attention not to the trade name of the drug, but to the main active ingredient and additional components (if they became the “culprits” of the violations).

It is important to understand that not only dental procedures are dangerous. The dentist should be aware of the presence of intolerance, but caution is required in other situations - for example, when using sprays and throat lozenges containing local anesthetics, as well as in preparation for gastroscopy and other procedures that require local anesthesia.

Drug therapy

To relieve the symptoms of allergic reactions are prescribed:

• antihistamines (Cetrin, Zirtek);
• topical glucocorticosteroids (Elokom);
• sorbents (Smecta, Enterosgel).

In most cases, drugs are taken orally in the form of tablets. The use of cutaneous agents - ointments, lotions - is required for dermatological lesions accompanied by a rash, itching. Sorbents play an auxiliary role, accelerating the elimination of allergens from the body, and are not prescribed for all patients.

For emergency care for anaphylactic shock, first of all, Adrenaline is required (it is also produced as part of the Epipen syringe pen for self-administration). Showing systemic glucocorticosteroids (Dexamethasone, Prednisolone), antihistamines (Suprastin) and other drugs (Mezaton, Ascorbic acid, solutions for intravenous infusion). These funds are also administered for urticaria, Quincke's edema.

Is it possible to find an alternative to local anesthesia?

The use of painkillers in dental practice has become routine and familiar not so long ago - until now, some experts suggest doing without an injection. It is worth noting that this, although it sounds scary, is actually a way out with simple manipulations - for example, the treatment of unstarted caries. But this option is not for everyone. Firstly, you need to have practically healthy teeth, and secondly, a high pain threshold.

Those patients who are terrified not even by buzzing, but only by the sight of a drill, with the development of sensitivity, find themselves in an extremely difficult situation. How to treat teeth with an allergy to anesthesia? There are two options:

1. Drug replacement.
2. Anesthesia (drug put to sleep).

In the first case, it is required to select a medicine in advance, to which there is no sensitization - for this, diagnostic tests are carried out (prick test, laboratory tests). It is worth considering that the risk of developing sensitivity does not disappear anywhere, and if a lot of time has passed after dental treatment, there is no guarantee that a reaction will not occur - a second examination is required.

Tests are performed with the drug that will be administered by the dentist - this way you can assess the likelihood of intolerance to all components contained in the ampoule.

Anesthesia provides a complete absence of pain (the patient is unconscious), however, it has contraindications - in particular, severe pathologies of the cardiovascular and respiratory systems. It can be characterized by various complications during drug sleep and after waking up - and among them there are also allergic reactions. It is worth discussing the need for anesthesia individually at a face-to-face consultation with a doctor, since it is almost impossible to correctly assess the level of risk and other important points remotely. In addition, it is often impossible to repeat the procedure, so it is better to plan the treatment of several problematic teeth at a time.

Allergy to drugs is one of the most difficult problems of modern medicine. If it is present, a person may be deprived of the medicines necessary for his health. But an even bigger problem is allergy to.

What can cause a drug allergy?

Drug intolerance is rare, but there are cases when a person is allergic even to iodine, not to mention the most complex components that make up the drugs that cause anesthetic sleep. It is almost impossible to predict this reaction.

An example of an allergic reaction from life: a young girl bought Japanese mascara, which included something from fish scales (secret cooking technology). After applying mascara to the eyelashes, anaphylactic shock developed within 2-3 minutes. Fatal outcome. There are no complaints about the Japanese, just an allergy.

Among the reasons that can provoke allergic reactions, it is worth highlighting:

• There is a connection between the use as toxic substances that can cause various kinds of reactions in humans. They can be individual and variable, and also manifest in many patients identically with similar symptoms.
• In medicine, medicines of a very complex and multicomponent composition are used. In view of this, individual intolerance can be traced.

Allergy to general anesthesia

Anesthetics have allergic potential. Latex, antibiotics, sleeping pills, dyes, colloids, and even sterilizers can cause an allergic reaction.

Local anesthetics are rarely tolerated. Negative consequences can be caused by inadvertent administration of the drug into the vessel.

Signs and symptoms of anesthesia allergy

Signs and symptoms of anesthesia intolerance can include any combination of cardiovascular, respiratory problems. However, skin symptoms may be present, but they are most often hidden by the drapes. Often the reaction concerns the gastrointestinal tract, but at the moment it is impossible to recognize it. Respiratory, circulatory, and skin symptoms are difficult to determine, since their severity can range from small rashes on the body after surgery to cardiovascular collapse. The severity of the reaction depends on the concentration of the substance and the way it is introduced into the body.

Allergy to anesthesia - a quick and correct reaction can save a life!

If a reaction occurs during drug sleep, an urgent need to diagnose and provide intravenous access. Such a set of measures will ensure high-quality treatment of anaphylactic shock. Tactics depends entirely on the clinical severity and the organs that were affected by it.

How can you prevent an allergy to general anesthesia?

The risk of future allergic reactions during medication sleep increases in people who have a drug reaction. If studies were carried out before the operation and the allergen was identified, then the preparations in which it is included are not used. But if the cause has not been established, the patient is prescribed a course of antihistamines and steroids. However, doctors have no evidence that such prophylaxis has an effect.

If a patient who has undergone anaphylactic shock has not been examined, then the decision to exclude certain drugs that can cause the development of a negative reaction of the body is quite justified. As a rule, anesthesiologists are ready to quickly diagnose anaphylaxis and bring the patient out of the crisis.

But people should always tell their doctor if they have an intolerance to certain drugs before starting general anesthesia. Many of the patient's assumptions are incorrect, and only in the course of a conversation, a thorough study of the medical record, is he able to draw the appropriate conclusions.

On the other hand, some people do not talk about intolerance to, for example, latex, considering itching from gloves or swollen lips after inflating balloons as an insignificant symptom that there is no need to tell the doctor about. Such negligence can cause the development of allergies during surgery.

At the same time, there is a category of patients who claim that they are "allergic to anesthesia." In most cases, this assertion is not supported by evidence. However, the consciousness of people enables the anesthesiologist to prevent the development of anaphylaxis for anesthesia.

The greatest achievement of modern science - anesthesia - is not so harmless, judging by the possible consequences. Medical statistics says that an acute reaction to anesthesia occurs quite rarely, once in 7 million patients. However, even such low figures will not reassure anyone. Therefore, it is important to understand that all the necessary information should be given to the anesthesiologist before the operation, and not after it.

I created this project to tell you about anesthesia and anesthesia in simple language. If you received an answer to your question and the site was useful to you, I will be glad to support it, it will help to further develop the project and compensate for the costs of its maintenance.

Related questions

Valery 27.02.2019 21:40

Hello. When I was a child, I had an operation according to my parents, the doctors were very frightened of the reaction to anesthesia. It was impossible to find out what kind of anesthesia it was and what happened now. As a teenager, on the advice of a doctor, I was tested for allergens to anesthetics used in dentistry. at least your teeth are healthy. The question is now I work as a driver. It worries me that if, as a result of an accident, I am taken to the hospital in an unconscious state, how can I warn doctors about an allergy to anesthesia? Perhaps a badge, like in the army with the inscription allergia anaesthesia, a note on my rights, other options?

Natalya 12.11.2018 15:16

Good afternoon, our baby is 1 year and 4 months old, 4 upper teeth are destroyed, the enamel is completely gone from one, we decided to treat it under anesthesia, because the child is still very small to just sit quietly in a chair with his mouth open, dentistry uses propofol anesthesia, how much is he safe? The baby had an allergy to amoxicillin in the form of a rash on the body, the baby also had the Epstein-Barr virus, is anesthesia safe for us in general?

Irina 10/17/2018 20:11

A week ago there was a correction of the auricles under general anesthesia. The next day, there was a very strong swelling in the nose, there was nothing to breathe, the ears were blocked, and tinnitus appeared. The surgeon said there were no questions about him. I went to the ENT, did a CT scan, no complications and inflammations, went to a neurologist, did an MRI, there is also nothing in her part. According to the recommendations, Laura used a vasoconstrictor for 5 days along with allergy sprays, it helps at the time of injection, it is easier to breathe, but the swelling does not go away. What could be the reason for such a sharp and strong edema, which has been holding for 10 days after the operation, and does not go away? And how to get rid of it? To whom will he turn?

Tamara 15.10.2018 14:00

Hello! The child is 1 year 2 months old, will have an operation (phimosis), I am very worried about how the child will endure anesthesia, as he is allergic! At 11 months, she had urticaria due to egg white, and Prednisolone was put on. On the advice of an allergist, she is now taking ketotifen (a course of 3 months). Tell me, how can we make sure? What should be done to rule out an allergic reaction to anesthesia? Maybe donate blood to determine allergies to drugs?

Elvira 08/05/2018 07:47

Hello! I am scheduled for a caesarean section. I am allergic, I have three types of allergies, allergic conjunctivitis, rhinitis and dermatitis. Should I be afraid of general anesthesia?

Sergey 25.07.2018 09:06

My brother is going to have a hernia operation. The anesthesiologist demanded a certificate from the allergist that he can tolerate anesthetic drugs, including general anesthesia. The allergist said that if there are no symptoms, then that he sneezes, there is no itching or spots, then he can be operated on. My brother has allergic rhinitis. Can he go for surgery with general anesthesia?

Marie 07/20/2018 00:41

Hello, doctor. Help me figure it out. The child is 1 year and 3 months old. A hernia repair is planned. Premedication plan: atropine 0.1% - 1 ml (i.m.), diphenhydramine 1% - 0.6 ml (i.m.), dexamethasone 1 ml (4 mg) (i.m.), ketamine 5 % - 2 ml (w / m). Further medicine thiopental and ditilin. What is the safe dose of these drugs (thiopental and dithylin) IV for a child weighing 9 kg 700 g, so that there is no overdose? 60 ml / 20 ml seems to be a bit much! Your opinion?

Julia 29.05.2018 22:30

Hello. My mom is having a hysterectomy. They did water anesthesia and anaphylactic shock happened. The operation was not carried out. Now they are preparing for spinal anesthesia surgery. The allergist has told or said, that tests to do or make it is not necessary. The anesthesiologist says it's possible to have a reaction to the anesthesia again. Tell me, please, how to be?

Arina 22.05.2018 19:50

I have a rhinoplasty operation, before that there were two unscheduled emergency surgeries and in both cases anesthesiology said I had a hard time enduring anesthesia, somehow it was not possible to ask them, Now I think I can check my heart on the "holter", although I'm not complaining, but suddenly there are hidden diseases And I also have gastritis. here's what they might mean

Maria 04/26/2018 18:38

The child is 1 year old. Elective surgery for excision of a left-sided inguinal hernia (laparoscopy was planned). All analyzes were normal. The child was not sick, the doctor was regularly consulted for professional examinations, the diagnosis was made "healthy", no medications (except for espumizan) were taken. Since the child is small, they tried to give food that did not cause allergies. The child tolerated all the necessary vaccinations normally, there were no background diseases, the parents are healthy. After the introduction of anesthesia - shock from anesthesia., death. They couldn't resuscitate the child, they didn't do the operation. Tragedy for parents!!! If this is an allergy to anesthesia, can there be such a reaction of the organism of a healthy child in our case? or the human factor? (overdose?, missed?, etc. What is your opinion? How could such an outcome have been avoided?

Maria 03/21/2018 17:53

Hello! February 2018 I had a thyroidectomy removed. The operation was performed under general intravenous anesthesia. After the operation, she could not open her eyes. , it seemed that the eyes dried up and the eyelids "stuck" to the eyeball, there was a strong dryness. After treatment with saline, everything ended safely. Lips swollen two days after surgery. The reception of suprastin helped. Then came itching and burning of the scalp and neck and rashes in the form of mosquito bites. This has been going on for a month now. Could this be due to anesthesia? Apart from L-thyroxine Berlin-Chemie and Suprastin, I do not use any drugs. She had been taking L-thyroxine before the operation since 2004 and there were no allergic reactions.

Tatyana 27.02.2018 15:05

Good afternoon. A child (2 years old) is to be operated on to remove dropsy of the testicle. The child is allergic (allergic to milk, sugar, citrus fruits, carrots, wheat), no allergies were observed to medications (except for those that contain sugar), I am very afraid that an allergy to anesthesia will occur. How to protect the child and is it possible to make some kind of allergy test for the components of anesthesia?

Olga 19.02.2018 16:19

Good afternoon! Tell me, is there an operation to remove the thyroid gland, how to check if there is an allergy to anesthesia? As a child, I was allergic to drugs, but with age, there seemed to be no problems, the fact is that I have bronchial asthma in everything, I am very worried

Valentine 02.02.2018 09:13

Child 11 will have an operation to remove a cyst on the testicle under general anesthesia. Do I need to be tested for allergies to anesthesia? The doctor says that he does not need this analysis. The child is not allergic. For reinsurance, I think it is necessary to hand over. What do you say?

Galina 01/30/2018 23:24

Hello. I'm having a caesarean section. I am very afraid of the reaction to spinal anesthesia. The 1st operation was done under general anesthesia and I felt fine. Now the doctor says that only spinal therapy, because I have a polyvalent allergy. I pass out when I was given a small dose of an anesthetic at the dentist's. Spinal anesthesia does not suit my mother at all! Why experiments? Here I am very afraid. Tell me, is it worth agreeing to a spinal or is it better for me to have a common one?

Natalia 01/30/2018 14:54 23.01.2018 16:10

Good afternoon! I am planning to do blepharoplasty. Tell me, please, what preliminary examinations can be done to exclude an allergy to anesthesia? I am allergic to a wide range of products (food), manifestation in the form of Quincke's edema, I have never had a reaction to medications before. I am very afraid of the operation, because. have a little daughter.

Faith 18.01.2018 12:38

Hello, please tell me if when you anesthetize a tooth with ultracaine, the pressure drops sharply, the lips turn white, it's hard to breathe ... Is it possible to do epidural anesthesia during childbirth or cesarean, I'm afraid of any reactions (((

Victoria 15.06.2017 15:53

Please tell me, after the operation (maxillofacial) my toes began to hurt, when walking. The anesthesia was local, but I received a total of 10 injections. Whether there can be it a consequence of an anesthesia?

Jamila 13.04.2017 00:41

Hello, I'm pregnant. And at the moment there is a question about a cesarean section, but I am very afraid not so much of the operation itself, but of the reaction to the drugs. Since 5 years ago there was a strong urticaria with angioedema, she lay in the hospital for 2 months. They did not reveal what. A year ago there was an anaphylactic shock on an antibiotic test (((cefatoxime (perhaps the sample was not diluted correctly), and recently they completely tried to drink a test dose of the antibiotic Arlet, after drinking suprastin in advance, and also gave a reaction. I am in despair, I don’t know what to do, I really it's scary every time to take something new. Plus, since childhood, I suffer from year-round allergic rhinitis. But I treated my teeth, and more than once, operated on my toe, and removed moles under local anesthesia, although after the last operation I was very dizzy. Now I'm afraid can I be given general anesthesia, or do spinal anesthesia, given that I am very allergic.Even iron preparations gave a reaction in the form of a small rash.What should I do???

Maria 06/23/2016 21:26

I had a gynecological curettage two weeks ago. But the reaction after anesthesia, in my opinion, was a little strange. There was a feeling that the face was swollen, the summer was slightly covered with spots, and the tongue was reduced so that she could not speak. The doctor said that I was nervous. This is not my first gynecological operation. The previous time anesthesia was transferred without any reactions. I would like to know what caused such a reaction.