The need to do allergy tests for anesthetics (dental, any other used for medical purposes) can arise in the life of any person. If the body is prone to a hypersensitivity reaction, a simple and relatively inexpensive test will accurately determine whether there are risks, which medicines are safe for a person, and which are associated with an escalation of anaphylactic shock, angioedema, and other manifestations of the body's hypersensitivity.
General information
Allergy to anesthetics is observed more often than to most of the drugs known to mankind. To some extent, the frequency of reactions with painkillers can compete with antibiotics. The peculiarity of an allergic reaction to anesthetics, especially those used for local anesthesia, is life-threateningpatient and systemic effects on the body. Consider everything in order.
It is customary to divide analgesics into those that have a local effect and provide general anesthesia. Local efficiency is characteristic of para-aminobenzoic acid ester compounds allocated to a separate category, and to all other drugs combined in the second class. The first group includes drugs containing pro-, tetra-, benzo-, chloropro-, cyclomethicaine. The second class is the anesthetic "Lidocaine", as well as common compounds: ultra-, mar-, brilu-, appli-, pramo-, mepiva-, ethido-, bupivacaine. Medications based on zincochaine, diclonin belong to the same category.
Features of allergies
As is known from the study of cases of allergy to anesthesia, cross-allergic responses are inherent in the first category of drugs. These are rarely found within the second category. Between these two classes, the probability of a cross-response is estimated to be zero.
As any allergist-immunologist will explain, the use of local anesthesia is always associated with an increased risk of an adverse response of the body. At the same time, anaphylactic reactions are observed in a small percentage of cases, a local direct toxic effect is recorded much more often. The area of drug administration swells, the patient's blood pressure decreases and the frequency and rhythm of the heart beat are disturbed, fainting is possible. Such reactions may be of an allergic nature or be explained by othermechanisms.
Opportunities and risks
As it is necessarily indicated in any instructions for use for "Novocaine" in ampoules, "Lidocaine", any other medication used for pain relief in medical practice, if there is reason to assume intolerance to analgesics, one should refuse to administer them. There are also cases when it is impossible to exclude the use of the drug. This is more common in dental practice. The only option is to replace local remedies with systemic drugs, but these are more likely to cause complications.
Assuming an undesirable response of the body, it is reasonable to conduct a special test in advance. Allergist-immunologists draw attention to the lack of definitive official conclusions regarding the reliability of skin tests, and yet they mainly begin to establish the possibility of a reaction with such measures. Having chosen the medicinal composition, it is used for a provocative skin test. It is necessary to resort only to such a remedy, which is not characterized by cross-effects with drugs that have previously caused a hypersensitivity reaction. In order to exclude a false negative result of the test, it is necessary to make sure that there are no agents in the medication that can constrict blood vessels.
Efficient and reliable
According to the instructions for use developed by manufacturers of analgesics ("Ubistezin" in dentistry, other drugs in medical practice) directly in the course of treatmentyou should resort to those drugs, the composition of which contains substances that constrict blood vessels. This helps to reduce unwanted systemic effects. In addition, sulfites, vasoconstrictive ingredients, very rarely provoke a hypersensitivity reaction. Adrenaline is often used as an additive.
Topical analgesics used for skin testing should not include paraoxybenzoic acid esters. These substances are more likely to provoke an allergic response.
Anaphylactic response
It is known that the probability of such a reaction during anesthesia is estimated as one case per 5-15 thousand patients. Mortality is estimated at an average of 5%. More often, this result provokes the use of muscle relaxants, drugs for induction anesthesia - all these drugs initiate the generation of histamine. It is known that more often the answer occurs at the first use. If an operation is planned, it is necessary to determine whether there were previously complications during anesthesia, what drugs were used. The patient will definitely have to do an allergy test for anesthetics.
It so happened that the very possibility of an allergic reaction, which was previously known, but little was said about, has begun to attract more and more public attention in recent years. This is noticeable not only in the practice of doctors who are forced to work with cases requiring general anesthesia. Allergies are becoming more common among dental clients, and many clinics are refusing to admit patients without prior testing.
Two sides of the same coin
Of course, when resorting to popular drugs (for example, in dentistry - "Ubistezin"), the instructions for use, containing an indication of the possibility of an allergic response, must be followed extremely strictly, and the manufacturer always indicates the need to refuse the remedy if there is a risk allergies are rated as high. On the other hand, the probability of a hypersensitivity reaction is estimated by some experts to be higher than the average for all patients without exception, and dental care without analgesics does not seem to be feasible today. In some cases, this is due to the discomfort of the client, in others it is simply impossible to perform the intervention without the use of pain medication.
Most often, parents of young children are interested in where to do allergy tests. Since the issue has become especially relevant in recent years, there is an opportunity to obtain information in any more or less large city. Samples are carried out by special laboratories. These are more often open at large dental clinics or research, laboratory centers and services. The cost of one study varies between 300-1000 rubles, specific price tags are determined by the city and the pricing policy of the medical institution.
How does it work?
It is far from always clear to the layman what an allergy is, what it can occur to. Of course, everyone knows that in the accompanying documentation for any medication, the manufacturer indicates that the product can provokean answer indicating increased sensitivity, but from the same accompanying instructions for use produced in Novocain ampoules, it is far from always clear how great the risks really are.
Professionals say that testing is mandatory for everyone and all the time is a pointless and thankless task. A reaction can occur unpredictably to any substance used in medicine, including an allergy remedy. A negative result of a once organized test does not guarantee that in the future a person will not encounter a condition indicating hypersensitivity.
And what to do?
It happens that the doctor to whom the patient turned for help (more often this is observed in dentistry) insists on conducting a skin allergy test for anesthetics. Such an event is entirely within the responsibility of the allergist-immunologist. Professionals with other specializations cannot take a sample, do not have such a right.
If an immediate allergic response occurs, the amount of allergen used does not matter. As a rule, allergy tests for anesthetics are done by people who are seriously afraid of anaphylactic shock. It must be remembered that even small amounts of medicines used for the study can escalate this response of the body.
Am I allergic?
It happens that a person needs planned treatment, while the measures involve anesthesia, and the patient himself does not have the slightestideas about possible allergic reactions inherent in his body. In allergology, a specific protocol for managing the patient has been developed specifically for such cases. It begins with a survey, the formation of an anamnesis. At the same time, the person reports on the substances introduced to him earlier and the reaction to them or its absence, and can also say that some medication has never been used before. Any of these options do not require an allergy test for anesthetics. If the procedure provokes an undesirable effect, the person is immediately provided with primary professional assistance.
If previous pain medications have triggered a hypersensitivity reaction, the doctor should refer the client to an allergist. Only after carrying out additional research activities, they begin the planned treatment of the patient.
It hurts, I can't
It happens that a person comes to the dentist's office because of a severe, acute toothache. Even in this case, the doctor must first interview the client, only then choose medicines to help. If a person reports a previously observed allergic reaction, the doctor does not have the right to accept it - it is necessary to redirect the patient to a hospital.
Some, fearful of being forced to be tested for anesthetics or sent to another ward, hide the fact that they have previously suffered hypersensitivity reactions to painkillers. This strategy comes with risks, not just a bad reaction, butlethal outcome. Of course, in any clinic, doctors have everything they need to help with anaphylactic shock, however, putting yourself in a vulnerable position is extremely unwise.
Where to go?
If a person consciously wants to undergo an allergy test for anesthetics, it is necessary to contact a clinic where qualified allergist-immunologists work. There are such institutions in any large settlement of our country. There are specialized rooms in state clinics; You can get a referral to see a doctor from your GP. The duration of the test is about 30 minutes, the results are usually ready in a week. Samples are most often recommended for people who need long-term treatment with antimicrobial and pain medications.
