2509. Package #626 (Allergy screening for anesthetics: Bupivacain, Mepivacain, Procain)

An anesthetic allergy is an immune system reaction to drugs used for numbing or pain relief. Anesthetics can be applied topically (applied to a specific area of ​​the body or injected under the skin) or systemically (injected into the bloodstream).

There are two main types of allergic reactions to anesthetics:

• Immediate (Type I) reactions occur within minutes of anesthetic administration and are caused by immunoglobulin E (IgE), released by the immune system in response to an allergen;
• Delayed (Type IV) reactions occur several hours or days after anesthetic administration.

Elevated IgE levels to bupivacaine, mepivacaine, or procaine indicate possible sensitization to the drug, which increases the risk of an allergic reaction with subsequent administration. This analysis helps to avoid dangerous allergic reactions during surgery or dental procedures and reduce the risk of life-threatening reactions such as anaphylaxis, allowing the selection of a safe alternative anesthetic.

A test for specific IgE antibodies to local anesthetics (procaine, bupivacaine, mepivacaine) is prescribed:

• in cases of a history of allergic reactions after anesthesia: itching, redness, urticaria, facial swelling, shortness of breath, anaphylactic reaction;
• to differentiate true allergy (IgE-mediated) from pseudoallergy or toxic effects;
• before planned surgery or dental procedures in cases of a history of allergy to anesthetics;
• in cases of cross-sensitivity to other anesthetics or preservatives (e.g., methylparaben).

This test is safer for the patient compared to skin testing (in vivo), as it eliminates patient exposure to the allergen.

• Venous blood

In order to exclude factors that may affect the test results, we recommend to follow the preparation rules: