局所麻酔薬によるアナフィラキシー様症状を示した児童に対して、リドカインチャレンジテストを施行した一例

Abstract

Anaphylaxis to local anesthetics occurs rarely. However,adverse reactions to local anesthetics are often similar to anaphylaxis, thereby causing difficulty in accurate diagnosis. This report describes the case of a 10-year-old boy who was suspected of a local anesthetic allergy due to impaired consciousness and convulsive seizures after administration of local anesthetics. The challenge test to lidocaine, which is one of the possible causative drugs, was performed. No allergic symptoms were observed following the subcutaneous administration of 1.1 mL of lidocaine, and the challenge test was judged negative. Although anaphylaxis-like symptoms often occur after administration of local anesthetics, the probability of actual allergy to local anesthetics is low. When a local anesthetic allergy is suspected in a patient, a challenge test to the suspected drug could accurately determine allergy and prevent its improper use or unnecessary avoidance in that patient.