Allergy to local anesthetics. Allergy to anesthetics in dentistry Reaction to anesthesia what to do

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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!

Toothache and tooth decay are problems affecting people of all ages, including children.

But not many are in a hurry to see a dentist, and the reason for this is not only the fear of upcoming manipulations, but also the fear of anesthesia.

Causes leading to an allergic reaction to anesthesia

Probably, many people have heard that during the administration of painkillers, a person may experience a serious allergic reaction, which is quite difficult to cope with.

You should not believe all the horror stories about the dangers of anesthesia in dentistry, but you should not assume that allergies are completely excluded during tooth extraction or its treatment.

Hypersensitivity when using anesthetics is quite possible, but its development by contacting a qualified doctor can be avoided.

Causes that lead to an allergic reaction to anesthesia:

• The doctor may choose the wrong method of anesthesia, or the anesthetic itself. It is necessary to have a complete picture of the presence of anesthetics, their mechanisms of action, indications and contraindications. Taking a patient history may also help.
• Another reason is the presence in the solution for anesthesia of not only an anesthetic drug, but also preservatives.
• The next reason is the composition of the anesthetic drug itself, for example, lidocaine has a complex composition, it includes additives that can cause an allergic reaction.
• Genetic predisposition, the presence of vegetative-vascular diseases, mental dysfunctions and other disorders. A common reason may be that all anesthetics have the potential to cause allergies.
• Another reason may be an incorrectly calculated dosage, the introduction of a large amount of a substance. All causes of allergy to anesthesia must be taken into account by the doctor.

What are the signs of an allergy to anesthesia?

Symptoms of allergy to anesthesia can be divided into three groups.

The first is reactions from the skin, the presence of rashes and itching.

The second group can carry a danger to human life, these are swelling of the face, neck and upper respiratory tract.

The third group is the most difficult. It starts with a tingling of the face, itching, then people feel weak, chest pain appears, if the doctor does not take action, anaphylactic shock, swelling of the airways, heart failure, convulsions may develop.

Types of Allergic Reactions That Can Occur During Anesthesia

Regardless of which anesthesia was used, the list of allergic reactions is the same.

Below are the types of allergic manifestations characteristic of anesthesia:

Anaphylactic shock

It develops within a few minutes after the drug enters the body. Symptoms include a lightning-fast drop in blood pressure, loss of consciousness, rapid heart rate, pale skin, swelling and spasm of the airways, and respiratory arrest.

In more than 20% of all cases, anaphylactic shock is fatal.

If the patient is not in the hospital, but, for example, in dentistry, urgently call an ambulance.

It is necessary within a few minutes, after the appearance of the first symptoms, to inject a person with adrenaline, glucocorticoids, intubate and connect to oxygen. If necessary, perform cardiopulmonary resuscitation.

Quincke's edema, or angioedema

It develops quickly after the introduction of the drug, to which the patient is allergic. Symptoms: swelling of the skin, mucous membranes, respiratory tract, joints. In rare cases, there may be swelling of the brain.

The consequences depend on the severity of the manifestation of the disease. If angioedema is manifested by brain damage and swelling of the airways, death may occur.

Treatment is the same as for anaphylactic shock. When the acute attack is relieved, the patient is prescribed antihistamines.

Hives

Characterized by the appearance of blisters, which are accompanied by severe itching.

Usually, the disease is not life-threatening. After the abolition of contact with the allergen, and the appointment of treatment - passes.

The treatment regimen includes antihistamines, sorbents, and plenty of fluids.

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.

How to know if you are allergic to anesthesia

The patient himself should have certain information about allergic reactions that have arisen in the past.

If you have ever had an allergic reaction to drugs, it is recommended that you always carry (in your bag, in your passport) a written list of such drugs for emergencies that may require an unscheduled operation, such as a traffic accident. In such cases, doctors will not have time to conduct a preliminary examination and prepare for surgery.

Always inform doctors about possible allergies to certain substances, do not forget to mention bad experiences with local anesthetics (for example, at the dentist). It would also be useful to know if any of your immediate family members had allergic reactions (what effect anesthesia had on family members who had operations under anesthesia), as well as about the medications that you have recently taken and past diseases.

The risk group of people with the possible development of an allergic reaction to general anesthesia includes children, the elderly, as well as people suffering from diseases of the cardiovascular system.

Always consult with an anesthesiologist before planned operations, agree in advance on a preliminary examination with the appointment of special tests - allergic tests. All allergic tests are divided into two groups - in vivo and in vitro tests.

The first, unlike the second, are skin tests and are carried out directly on the patient. To date, there are a large number of allergy tests that do not require intervention in the patient's body, since they are carried out in vitro - in vitro tests, for example, the RTML test (reaction of inhibition of leukocyte migration).

As a result of such tests, the doctor will have an idea of ​​which drugs and substances your body will tolerate and which will reject. Based on this, experts will decide in favor of using one or another anesthetic.

And the last thing: the most important condition for the timely detection and avoidance of an allergic reaction of the body to general anesthesia is strict adherence to all recommendations and instructions of the doctor both during the preliminary examination and immediately before surgery.

What to do if an allergic reaction occurs

It is impossible to protect one hundred percent from anaphylactic shock.

But in order to reduce the risks, anesthesiologists ask a person in great detail about the presence of allergies, intolerance to drugs and products.

It happens that a food allergy does not allow the use of a certain drug. For example, if you are allergic to eggs and soy, you should not use propofol. To prevent anaphylaxis, anesthesiologists use antihistamines and glucocorticoid hormones before surgery, which should reduce the severity of the allergic reaction. Due to the lack of evidence base, this recommendation is often criticized.

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.

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, the anesthesiologist is able to draw the appropriate conclusions.

Often in the dentist's office you can hear the question: does the patient suffer from an allergy to anesthesia? The reason lies in the individual characteristics of the organism. This greatly complicates the process of dental treatment. Allergens hide in the composition of anesthetics and often cause an unwanted reaction.

Reasons for the reaction

Allergy to anesthesia in dentistry occurs with increased sensitivity to the components in the composition of drugs. There are local and general anesthetics. Any of them can cause an aggressive reaction of the body.

Features of the use of drugs

Local anesthesia is carried out with the help of special preparations. When they act, the sensitivity of a certain area disappears completely. This helps the doctor calmly perform various procedures that cause severe pain.

Painkillers of general action are rarely used. This requires serious injuries and damage to the jaw. Therefore, the doctor rarely uses such anesthetics.

Local anesthesia

Local anesthesia is used in such cases:

• caries;
• removal of a tooth;
• preparation of teeth for prosthetics.

This therapy is used to treat teeth and caries in children of different ages.

General anesthesia

The dentist uses it for such pathologies:

• face and jaw injuries;
• removal of cysts from the maxillary sinuses;
• removal of several teeth.

The duration of this anesthesia is longer than the local one.

Types of anesthetics

• sprays, for spraying pain medication on the gums;
• infiltration;
• conductive;
• intraosseous;

General anesthesia is carried out in the form of an injection.

Reasons for the reaction

The following factors can cause intolerance to anesthesia:

1. genetic predisposition.
2. tendency to react.
3. Incorrectly selected anesthetic.
4. Drug overdose.

Often in dental practice, there is a reaction to anesthesia, due to the carelessness of the doctor. This is due to the wrong dosage. The lack of tests, diagnosis, history taking, provokes an undesirable reaction.

In addition, the drug itself may be to blame. Preservatives and other components in its composition are allergenic. The risk increases if a medicine with a multicomponent composition is used.

Allergy symptoms

This pathology can be manifested by symptoms of varying complexity. It is not uncommon for severe symptoms to occur. The main ones include:

• skin redness;
• rash, itching, urticaria;
• swelling on the face, mucous membranes of the upper respiratory tract;
• weakness;
• dizziness;
• nausea;
• headache;
• drowsiness.

There is a risk of angioedema and anaphylactic shock. They pose a threat to life and require immediate medical attention. Any component can be an allergen.

Important! After the introduction of anesthesia, symptoms of mild complexity are usually observed. Mostly they pass on their own, without complications.

Signs of a reaction with local anesthesia

This reaction rarely occurs with modern drugs. Also, serious complications do not often occur. Allergic symptoms in this case are characterized by such manifestations:

1. On the part of the skin - redness, rashes, peeling, itching.
2. Edema on the face - begins on the lips, then the mucous membranes.
3. Weakness.

Often occurs in allergy sufferers who suffer from a reaction to medications.

Allergy symptoms during general anesthesia

During general anesthesia, the patient may experience the following symptoms:

• tachycardia;
• increased sweating;
• nausea;
• dizziness;
• hives.

How do you know if you are allergic to an anesthetic?

To find out what exactly causes allergies, various diagnostic methods are carried out. Skin tests, laboratory tests will help to find out. Determine the best provocative samples. It will be useful to know for those who are interested in how to find out if there is an allergy to anesthesia.

Suspected allergens are applied to the patient's skin. After a short time, the doctor evaluates the result. If the skin turns red, then this confirms the presence of an aggressive reaction of the body to a certain medicine.

Laboratory studies are also needed in this case. An allergy sufferer is prescribed a general blood test and enzyme immunoassay. The latter helps to determine the presence of antibodies in the blood to certain antigens.

How to treat the disease?

Treatment is standard. It all depends on the degree of complexity of each symptom. From manifestations on the skin and edema, Diphenhydramine, Suprastin are administered intramuscularly.

If symptoms of anaphylactic shock occur, the patient is injected with adrenaline and an ambulance is called. Basically, this is enough to remove the signs of pathology and anticipate their severe development.

Complications do not occur often with timely treatment. If you carefully study the patient's history and conduct the necessary tests before anesthetizing, then the risk of allergies will decrease.

In addition to antihistamines, sorbents should be taken. They contribute to the rapid removal of the allergen from the body. Activated carbon and Polysorb effectively help in such cases.

First aid for severe reactions

First aid for severe symptoms is provided by a dentist. He injects with adrenaline and has to call an ambulance. The patient is taken to the clinic to provide drug therapy and manage complications. In this case, they are treated not only with antihistamines, but also with medicines to support general health.

Relief of mild to moderate symptoms

Many do not know how to treat teeth if they are allergic to anesthesia. To avoid signs of allergies, you should increase immunity. You can find out what causes reactions before treating a tooth.

If it is impossible to do without anesthesia, a certain therapy is carried out. The bottom line is that the patient is given the minimum dose of the drug over time. Determine what the irritant is hiding in, and gradually increase the amount of its introduction. After that, intolerance to the allergen practically does not manifest itself.

Folk methods of treatment

It is difficult to cure this pathology with folk remedies. They help to reduce its manifestations and improve the patient's well-being. They are used with extreme caution. Usually helps stabbing, massage, breathing exercises.

Proper breathing helps asthmatics. Herbs are recommended to be used only if there are no contraindications. There is a high risk that they will increase the manifestation of an allergic reaction. In order for patients to treat such a pathology with traditional medicine, there must be permission from the attending physician.

How to treat teeth if allergic to anesthetic?

Every dentist should know this. Before anesthetizing, he must check the patient's body for allergies. Usually the reaction is manifested on a specific component, and not on drugs in general.

If one anesthetic does not fit, then it can be replaced with another. The following analogues are considered effective and safe:

• Lidocaine with a vasoconstrictor;
• mepivacaine;
• Artican.

A certain drug can be used by allergy sufferers, pregnant and breastfeeding women. Children were anesthetized with such medicines. If a child goes to the dentist for the first time, he must be diagnosed with allergies.

Disease prevention

Dentistry should be approached responsibly and seriously. You should choose high-quality dental clinics that employ real professionals. Since in most cases, the reaction to anesthetics depends on the doctor. This is the main advice in prevention.

A dental problem can sometimes be solved only with the use of sophisticated therapy. Therefore, dentistry widely uses drugs with a strong analgesic effect. Often the pathology develops in children. If there is a tendency to such pathologies or a reaction to medications, this should be reported to the doctor. He will select a safe drug. Allergy sufferers should always increase and strengthen the immune system. This will reduce the risk of developing new pathologies.

Drug allergy is an important problem of the modern medical community. In the presence of such a person, the medicines that he needs may be contraindicated, and therefore the most effective treatment. Another facet of this problem is reflected in the patient's inability to transfer anesthesia sleep, which he needs for treatment or surgery.

What causes and how are allergic reactions to drugs manifested?

1. First of all, there is a connection due to the use of toxic and poisonous substances as anesthetics, which can cause various reactions and manifestations in humans, which can be individual and variable, or manifest in all patients the same way or with similar symptoms.
2. In modern medicine, drugs are used, consisting of many components, it is because of their combined action that patients began to show individual intolerance to the substances used in anesthetics. This can be corrected by replacing the allergen with another component.
3. The manifestation of the reaction may be different, but there are similar reactions, as a rule: increased heart rate, chills, accompanied by fever, dizziness, feeling unwell, fatigue.

The main symptoms of allergies:

• rash,
• skin redness,
• dyspnea,
• suffocation (difficulty inhaling and exhaling).

And the most severe and extreme case is anaphylactic shock, which often ends in death.

Allergic manifestation to general anesthesia

General anesthesia is a state of sleep caused by the action of medications that, acting on the patient's consciousness, make it possible to carry out medical interventions without bringing discomfort and pain to the patient. It is used in manipulations requiring anesthesia. The state of sleep occurs after the introduction of special chemicals into the body.

Consequences of the introduction of chemicals aimed at introducing a person into an anesthetic state

1. The occurrence of heart failure . There are several reasons for this complication: firstly, it is an overdose of drugs necessary for anesthesia, and secondly, it is due to diseases of the cardiovascular system more often than chronic ones, although mortality from the second cause is less likely.
2. Allergic reaction. The problem of this is most often the ignorance of the patients themselves about the allergic reaction to medications or their components.
3. The occurrence of respiratory failure. It can occur due to diseases of the respiratory system, most often it is asthma.
4. The most common cause, unfortunately, is related to the human factor. , insufficient qualification of a specialist or poorly prepared process of surgical manipulation.

Allergy after drug sleep

There may be manifestations of allergies after anesthesia, even if the surgical intervention occurred at the proper level and there were no complications. As a rule, they are not fatal, but still there is little pleasant in them. Hair may begin to fall out, skin flakes, nails break, teeth crumble, etc. It is impossible to predict them, the only thing that needs to be done is to inform the patient about the possible risks and consequences of anesthesia.

Drugs for allergic reactions

These drugs are sedative, that is, they block the receptor that is responsible for the allergic manifestation and reaction, another plus in their use is the possession of a sedative effect, drugs of this type are used in the treatment of neuroses, frustration, insomnia, the initial stage of hypertension. Here are a few drugs from this list:

• Fenkorol;
• Peritol;
• Dormiplant and others.

Treatment with folk methods

Preparation of decoctions from raspberries. Cooking method:

• Take 50-60 grams of raspberry roots, put them in a saucepan or any other utensil, pour 0.5 milliliters of water and boil over low heat for no more than 40 minutes, take the resulting broth 2 tablespoons 3 times a day.

A decoction of rose hips. You can drink during pregnancy. Rosehip has a number of properties, one of which is the improvement of the immune system. Cooking:

• take 5-6 rose hips, pour 50 milliliters of hot water and wait 30 minutes. Take no more than 5 times a day in the amount of 50 milliliters per 1 dose.

Chamomile flower infusion:

• Pour two tablespoons of chamomile flowers with 2 cups of boiling water, let stand for 30 minutes. Take no more than 4 times a day.

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.