Hyperresponders and adrenaline in local anaesthetic solutions

The presence of adrenaline in local anaesthetic solutions may cause disturbing systemic reactions in some patients. Putative allergies of 532 patients to local anaesthetics were investigated over a 15-year period in a clinic and 163 patients were found to experience these reactions, of whom 99% were female. Only 17 of these patients took drugs for the treatment of cardiovascular diseases; 11 of them were on thyroid replacement therapy. Practitioners should be careful not to attribute these systemic reactions to an allergic drug response. Furthermore, the medical history and drug intake of patients must be revised regularly.