The incremental challenge test in the diagnosis of adverse reactions to local anesthetics

Objective, The aim of this study was to assess the reliability of a diagnos tic protocol, the incremental challenge test (ICT), for patients with and w ithout a history of adverse reactions to local anesthetics (LAs) or other d rugs, to select an LA that could be safely used. Study design. The ICT was performed on 432 subjects, 314 female and 118 mal e. Four hundred thirty-two challenges were carried out with LAs that were f ree of adrenaline and preservatives. Chi-square analysis was performed to e valuate the existence of different predispositions to ICT positivity among subjects of the 4 categories studied. Results. Four hundred fifteen tests were completed with no clinical events occurring. The analysis did not show any significant difference (chi-square = 6.17; P > .05). Conclusions, Our results confirm that immunoglobulin E-mediated reactions t o LAs are uncommon and that the ICT offers safety and specificity in diagno sing adverse reactions to LAs, allowing for the selection of a safe and rel iable LA.