Local anesthetic allergy. Its recognition and avoidance

Local anesthetics are perhaps the most important drugs used in dermatologic surgery. They allow a variety of procedures to be performed safely and comfortably. Although generally well-tolerated, patients frequently report adverse reactions to these agents and may be labeled as "caine sensitive". In this review we will discuss the approach to the patient with possible local anesthetic sensitivity and in particular will focus on the role of skin testing and challenge in evaluating these patients.