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Risk Factors for Immediate-Type Local Anesthetic Hypersensitivity Reactions in Pediatric Patients: A Retrospective

Ayse Suleyman1, Zeynep Tamay1, Nermin Guler1

  • 1Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Allergy and Immunology, Istanbul, Turkey.

Journal of Asthma and Allergy
|April 15, 2022
PubMed

Insights

Immediate local anesthetic hypersensitivity in children is rare but can occur. Repeated exposure and skin reactions are key risk factors for developing this allergy.

Area of Science:

  • Allergy and Immunology
  • Pediatric Anesthesiology
  • Pharmacology

Background:

  • Immediate local anesthetic (LA) hypersensitivity reactions are uncommon.
  • Limited data exists on risk factors for LA hypersensitivity in pediatric populations.

Purpose of the Study:

  • To identify risk factors associated with immediate local anesthetic hypersensitivity in children.

Main Methods:

  • A retrospective case-controlled study was conducted.
  • 17 patients with confirmed immediate LA hypersensitivity were compared to 3 age- and gender-matched controls.
  • Skin tests and subcutaneous drug provocation tests were used to confirm LA hypersensitivity.

Main Results:

  • Cutaneous manifestations were observed in 82.4% of patients versus 13.7% of controls.
  • A history of repeated LA exposure (≥2) was present in 64.7% of patients compared to 11.8% of controls.
  • Repeated LA exposure (OR: 5.7) and cutaneous findings (OR: 17.3) were significant risk factors.

Conclusions:

  • Cutaneous manifestations are a significant predictor of LA allergy in children.
  • Repeated exposure to local anesthetics increases the risk of developing hypersensitivity.
  • Skin testing is crucial for confirming LA allergy in pediatric cases.
Abstract

Keywords:
childrenhypersensitivityimmediate reactionslocal anestheticpredictive factorsskin testsubcutaneous provocation test

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