ALLEGED ALLERGY TO LOCAL-ANESTHETICS

The aim of this study was to determine the incidence of true local ana esthetic allergy in patients with an alleged history of local anaesthe tic allergy and whether subsequent exposure to local anaesthetics is s afe. Two hundred and eight patients with a history of allergy to local anaesthesia were referred over a twenty-year period to our Anaestheti c Allergy Clinic. In this open study, intradermal testing was performe d in three patients and progressive challenge in 202 patients. Four pa tients had immediate allergy and four patients delayed allergic reacti ons. One hundred and ninety-seven patients were not allergic to local anaesthetics. In 39 patients an adverse response to additives in local anaesthetic solutions could not be excluded. In all but one patient l ocal anaesthesia has been given uneventfully subsequently. A history o f allergy to local anaesthesia is unlikely to be genuine and local ana esthetic allergy is rare. In most instances LA allergy can be excluded from the history and the safety of LA verified by progressive challen ge.