Sensitivity to local anaesthetics among asthmatic children

Although true allergic reactions to local anaesthetics are rare in the general population, the importance of the problem among asthmatic children has yet to be documented.

Skin prick, intradermal and incremental challenge tests with lidocain were performed in 157 asthmatic children aged 8-15 years and compared with 72 nonasthmatic children of a similar age. All of the asthmatic subjects were allergic to at least one allergen, most frequently pollens and house dust mites. Prick testing began with an undiluted solution in patients without a history of allergy and with 1:100 dilution in those with a reaction history. Following negative prick testing, intradermal or incremental challenge tests were performed.

A total of 125 patients (80%) had been given local anaesthetics in the past, only three children gave history of an adverse local reaction. At the end of the tests, none of the subjects including controls, were found to have immediate or delayed-type allergy to lidocain.

Local anaesthetic allergy does not seem to be a serious problem among asthmatic children and testing in all asthmatic children is not warranted. Those with an adverse reaction history to local anaesthetics should be tested with these drugs.