Local anesthetics �
True allergic reactions to local anesthetics resulting from mast cell degranulation are thought to be rare. Skin testing and graded challenge protocols have been published and may be administered by an allergist prior to the surgery if questions arise regarding the safe use of a local anesthetic in a patient.
If possible, preservative-free local anesthetic should be used in these tests, as the preservative often present in local anesthetics can cause a mast cell reaction. In general, local anesthetics in the �ester� group should be avoided. This group includes procaine, chloroprocaine, tetracaine, and benzocaine. Anaphylactic reactions to local anesthetics in the �amide� group are rare. This group includes lidocaine, mepivacaine, prilocaine, bupivacaine, levobupivacaine, and ropivacaine. |
