Allergy to anesthesia in children. How does allergy to anesthesia manifest itself? Symptoms on local anesthesia

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 body. 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:

genetic predisposition.
tendency to react.
Incorrectly selected anesthetic.
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:

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

Allergic reactions to drugs have recently become the most common occurrence among the population. Especially allergic to anesthesia causes great problems for patients. Since anesthesia is used during surgery, a thorough history is taken before its use and they approach this method of anesthesia with great responsibility.

Narcosis and its varieties

Local anesthesia- this is a loss of sensitivity of any organ, which is caused artificially.
General anesthesia - this is when the patient has complete insensitivity and is put to sleep with loss of consciousness.

An allergic reaction to an anesthetic in a patient may occur during surgery or after surgery after a certain time.

Allergy to anesthesia

The reaction to the injected anesthetic drug may occur instantly or 10-15 minutes after the injection. The most formidable complication of allergy to anesthetic is anaphylactic shock. All medical institutions have drugs for first aid during anaphylactic shock.

When a patient falls asleep under the influence of anesthesia, it is very difficult to determine an allergic reaction to it. In this case, the following symptoms appear:

Rapid drop in blood pressure.
Tachycardia.
Loss of consciousness.
Paleness of the skin.
Swelling of the airways.
Stopping breathing.

In many cases, anaphylactic shock after an allergy to an anesthetic can lead to death.

Allergy after anesthesia

In fact, anesthesia is not a safe means during surgery, after which the following effects of anesthesia may appear:

Exacerbation of heart disease that anesthesia can provoke when the patient has chronic diseases of the cardiovascular system.
Allergic reaction.
Respiratory disorders that occur in people with diseases of the respiratory system, such as bronchial asthma.

After anesthesia, patients with allergies may experience the following symptoms that appear after awakening from anesthesia:

Strong fragility of hair and their increased loss.
Fragility of the nail plate.
Various skin rashes.
Skin itching.

Symptoms

Depending on the method of administration and the amount of the allergen in the composition of the drug, the symptoms during and after an allergy to the anesthetic are as follows:

Redness of the skin.
Tingling and itching.
Difficulty breathing.
Various skin rashes.
Brittle nails.
Abdominal pain.
Edema.
Pain in the injection area.
Pain in the chest.
Feelings of fear and anxiety.

The reasons

There are a lot of reasons for the appearance of an allergy to anesthesia, these reasons are as follows:

Individual intolerance to the drug as part of the anesthetic.
Error in the selection of the dose of the drug.
Insufficiently trained anesthesiologist.
Toxic substances that are part of the anesthetic substance.
May be allergic to suture material, gloves, sterilization products, and surgical instruments.

First aid

If a reaction to anesthesia occurs in a patient in a hospital or any other medical institution, doctors will always come to the rescue and provide appropriate assistance. Since such cases mainly occur during surgery, first aid medicines are available in all operating rooms.

If the patient has symptoms of allergy or anaphylactic shock (redness of the skin, swelling of the face, hoarse voice, wheezing, low blood pressure and a feeling of fear), the following measures are recommended:

Apply a tourniquet above the anesthetic injection site.
Inject 0.1% epinephrine 0.5 ml under the skin or into a vein.
Inject prednisolone into a vein or muscle.
Give the patient any antihistamine that is at hand (diphenhydramine, fencarol, diazolin, suprastin, tavegil, claritin, loratadine, fenistil, and others).

Prevention

For preventive purposes, the patient must undergo a thorough examination before the operation, undergo allergy tests and provide the anesthetist with all the necessary information about himself.

In medical practice, it has been proven that an acute allergy to anesthesia can occur in very rare cases, but nevertheless these facts do not reassure. To determine an allergic reaction to any drug in the composition of the anesthetic, the following examinations are carried out:

Various skin tests.
ELISA blood test.
Allergen challenge tests.

No one can guarantee anyone that after anesthesia there will be no allergic reaction. To reduce the risk, the anesthesiologist carefully collects an anamnesis, asks about all manifestations of allergies from birth to the present. As a preventive measure, antihistamines and hormones are prescribed before surgery to reduce allergy symptoms. These medicines reduce the symptoms of allergies.

Recently, anesthesia has been used very often in dentistry. When a patient feels fear of dental treatment, experiences a strong fright, his blood pressure may rise, he may have a heart attack and dizziness, he may lose consciousness. To prevent such phenomena, dental anesthesia is used, which can be prescribed to the elderly, children and people of all ages.

Summing up, we can say that in any situation, before using anesthesia, it is recommended to approach the problem of allergies with caution.

Everyone at least once in their life faced with the need for anesthesia. It can be a major operation or a simple dental treatment. Any type of anesthesia is not harmless and carries a potential danger in the form of an allergy.

Allergy to anesthesia is severe, sometimes doctors do not have time to save a person. Therefore, patients should know how to determine if they have intolerance to anesthesia, and how to replace it.

Drug intolerance occurs in 1% of people, among all cases of allergy, it is diagnosed in every tenth patient. A drug allergy is an immune reaction to a specific drug caused by hypersensitivity to it.

The initial intake of the drug starts the process of sensitization, this substance becomes an allergen for a person. When taken again, mast cells are activated, which release histamine into the blood.

This leads to irritation of the nerve endings, spasm of the musculature of the vessels, increased secretion of mucus, and expansion of the capillaries. This causes the appearance of the main symptoms of allergies - itching, rash, swelling, anaphylaxis.

There is also a delayed immune response, when leukocytes rush to the site of inflammation, and the inflamed cells are replaced by connective tissue. These consequences are very serious, as they lead to the development of dangerous pathologies in the form of thrombocytopenia, hemolytic anemia, vasculitis, and serum sickness.

Peculiarity

Anesthesia, or anesthesia, is a special preparation for reducing the sensitivity of the whole body or part of it. The transmission of the nerve impulse is blocked, which allows for surgical manipulations.

In medicine, 2 types of anesthesia are used:

General (anesthesia). The patient completely loses sensitivity and is unconscious. Anesthesia is simple and combined. It is performed by inhalation or by injecting the drug into a vein.
Local - turns off the sensitivity of a certain part of the body or area. The patient is then conscious.

Local anesthesia is divided into:

spinal. The anesthetic is injected into the subdural space (where capillaries accumulate).
epidural. The drug is injected into the epidural space (where the veins pass). In both cases, the impulse is blocked at the level of the spinal roots. Perform minor operations on the lower body, caesarean section, etc.
Conductor. The impulse is blocked at the level of the nerve endings or the nerve trunk.
Infiltration. They block small nerve receptors and pain receptors. This includes anesthesia in dentistry.
Contact (application). An anesthetic application is applied to the skin or mucous membrane, anesthesia of the surface layers of the skin occurs.

Fluorotan, Methoxyflurane, Hexenal, Ketamine, Etomidat are used as anesthetic drugs for general anesthesia. For local anesthesia, Lidocaine, Novocaine, Benzocaine, Prilocaine are used.

An allergy occurs both to the main active substance, for example, Lidocaine, and to other components. The composition of anesthetics may include adrenaline, stabilizer, preservative, parabens, known for their allergic properties.

Peculiarity! According to statistics, an allergy to general anesthesia occurs in one in 15,000 cases, but is almost always acute and ends in death.

The reasons

The main reason for an allergic reaction to anesthesia is intolerance to the components of the drug. A reaction to general anesthesia can happen to anyone for an unexplained reason.

Among the provoking factors are:

a history of allergies;
pathology of the endocrine system;
bronchial asthma, diabetes;
hereditary predisposition;
constant contact with chemicals.

The likelihood of developing an allergy to an anesthetic increases with the rapid administration of the drug, the use of the drug on an empty stomach, the use of anesthesia after a serious illness, and the simultaneous use of several medications.

Symptoms

The response to anesthesia is immediate and delayed. Most often, the first signs occur an hour after general or local anesthesia. This allows doctors to take the necessary therapeutic measures.

In cases of a delayed reaction, which manifests itself after 12-24 hours, the patient does not always associate the worsening of the condition with anesthesia and starts improper self-medication, thereby aggravating the situation.

The clinical picture of an allergy to general anesthesia is usually expressed in systemic manifestations:

angioedema;
swelling of the larynx;
respiratory depression;
heart failure;
pressure drop.

In these situations, minutes count, otherwise the patient may die.

Anaphylaxis also occurs with local anesthesia. Lidocaine is especially dangerous. Novocaine and Benzocaine are less likely to provoke pathological reactions.

Symptoms of local anesthesia:

redness, pain, swelling of tissues at the injection site;
hives;
lacrimation;
rhinitis;
itching and blisters on the skin;
small red dots localized on the elbow and knee folds;
epigastric pain;
bouts of vomiting;
diarrhea;
headache, loss of consciousness;
angioedema.

If resuscitation is not carried out in time, this will lead to death.

Important! In some cases, negative symptoms are not caused by allergies, but by the patient's weakened health or a violation of the dosage of the drug. This usually happens when using general anesthesia, especially intravenous. Many components in its composition have a strong toxic effect, therefore, they inhibit the activity of the heart and lungs.

The risk is increased in patients with heart or kidney failure, serious chronic diseases. In these cases, local anesthesia is recommended. If this is not possible, it is necessary to choose the exact dosage and type of anesthetic, and during the operation, the anesthesiologist must constantly monitor the patient's condition.

Possible consequences

Allergy to anesthesia is the most dangerous of all cases of drug allergy. The patient is unconscious or sensory disabled, so they are unable to signal that their condition is deteriorating. The doctor can judge this only by objective signs, when precious time has already been lost.

The most dangerous consequences of allergies:

respiratory depression and heartbeat;
increased blood clotting, which is deadly under conditions of surgery;
violation of the functioning of internal organs, which can lead to death.

No less dangerous and delayed consequences:

thrombocytopenia;
hemorrhagic diathesis;
serum sickness.

These diseases can make a person disabled.

Diagnostics

Usually, the fact that the patient has an allergy to anesthesia becomes known already at the time of the onset of symptoms. However, people who are prone to allergies need to be aware of this in advance to avoid fatal complications.

It is impossible to independently check whether there is an allergy to anesthesia. Before visiting a dentist or surgery, you should consult an allergist and an immunologist. How to check if there is a reaction to anesthesia:

ELISA blood test. Detects the presence in plasma of specific antibodies to proteins.
Measurement of the level of histamine in the blood.
Skin tests. They are the simplest and most informative for diagnosing allergies. Micro-notches are made on the forearm, then a solution of the alleged allergen is dripped onto them. Redness and swelling indicate a positive reaction.

What to do

Treatment of allergy to anesthesia is urgent and planned. Urgent involves resuscitation if systemic reactions have developed. The patient is injected with Adrenaline and Eufillin to normalize cardiac and pulmonary activity, Prednisolone - to relieve inflammation. After stabilization of the condition, therapy with antihistamines and detoxification drugs is carried out.

Routine allergy treatment is prescribed for mild allergies to eliminate symptoms and prevent complications. The following medications are prescribed for treatment:

Antihistamines (Zodak, Zirtek, Erius, Diazolin).
Enterosorbents (Polysorb, Filtrum).
Local remedies - Fenistil Gel, Allergodil, Vizin Alergi.

Important! Folk remedies for the treatment of allergies to anesthesia are inappropriate and dangerous to use.

What to replace

If a patient has been diagnosed with anesthetic intolerance, but urgently needs surgery or dental treatment, then an alternative should be selected based on the results of the examination.

For example, with intolerance to Lidocaine, a person can easily tolerate Novocaine or Benzocaine. Dental treatment under anesthesia is also possible, although this is also unsafe for an allergic person.

If surgery is necessary, discuss the possibility of using local anesthesia. Many operations are now successfully performed under epidural or spinal anesthesia. An alternative to intravenous anesthesia is mask or endotracheal, where fundamentally different drugs are used.

Useful video: what is general anesthesia

For information on what anesthesia is, see the video below.

conclusions

Allergy to anesthesia is very rare, but its consequences are almost always deplorable. Therefore, allergy sufferers should be vigilant and conduct a preliminary diagnosis.

In contact with

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:

With rapid administration of the drug.
When using an anesthetic on an empty stomach.
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 disorders 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 caveat: when a 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) features

This is a group of symptoms, the area of manifestations during the development of which is limited to the contact zone - that is, the site of drug administration. Allergy to anesthesia is characterized by:

Edema.
Redness (hyperemia).
Feeling of fullness, pressure.
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 "nettle fever", 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. It is localized mainly in the area:

Eye, nose, lips, cheeks.
Oral cavity.
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:

Weakness.
Dizziness.
Tingling and itching of the skin.
Urticaria, angioedema.
Nausea, vomiting.
Difficulty breathing.
Sharp pain in the abdomen.
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 a dental intervention (in order to assess the likely risk) or within a day from the onset of symptoms (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 when determining the likelihood of sensitivity to local anesthetics in dentistry. Conducted using:

Compact lancets.
Allergen substances.
Diluting liquid.
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 that, 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 provoking 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:

Drug replacement.
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 during 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.

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 the use of local anesthetics (for example, at the dentist). It will not be superfluous to provide information about whether your immediate family members have 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 (leukocyte migration inhibition reaction).

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 the 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 to 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 reaction to drugs. 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.