Abstract
Allergy to local anesthetics is a disease with relatively low incidence at present. In particular, there has been almost no report on a “true” lidocaine allergy. In the present report, we will describe our recent experience on a case, which seemed to be lidocaine allergy.
The patient was a 20-year-old woman, who underwent tooth extraction at a local dental clinic when she was 18 years old, whereby she had her eyelids swollen and visual field contracted due to local anesthesia. Thus, for pulpectomy, intracutaneous reaction test using lidocaine and lymphocyte stimulation test (LST) were performed. The results of the tests were negative. Local anesthesia was performed with 3ml of 2% lidocaine or intravenous inqection. under intravenous sedation. After 2-3 minutes of injection, swelling of eyelids appeared. At this moment, allergy to local anesthetic not being subject to immunological system was suspected. Allergy test using placebo was performed later, but the result was negative. Further, as the result of load test with 2% lidocaine for intravenous injection, swelling of eyelids appeared by 100%, but no other allergic symptoms such as rashes did not occur. In view of the subsequent therapeutic program, hyposensitization therapy was adopted because there may be very low possibility to lead to anaphylaxis in the present case, and satisfactory results were obtained.
