Have itching and allergic reactions been reported as side effects of articaine and epinephrine (Sep

Fråga: Have itching and allergic reactions been reported as side effects of articaine and epinephrine (Septocain forte)?

A 7-year-old boy recieved Septocain forte for local anesthesia during a dental procedure. He suffered from a burning sensation and pruritus that was so severe that he scrathed his cheek into bleeding.

Sammanfattning: Allergic reactions to articaine have been reported in a few cases. One case report of itching following articaine injection was found.

Svar: Allergic rections to local anesthetics are very rare. About 0,5% of adverse drug reactions due to local anesthetics are caused by allergy to the drug. Most adverse reactions are psychogenic or vasovagal reactions (1,2).

Nonitching erythematous skin rashes are however common adverse reactions to articaine. Eight out of ten patients suffered from rashes after local injection of articaine into the arm. Symtoms disappeared within an hour after injection. The authors suggested that this reaction might be due to venous endothelial irritation and not to an allergic reaction. Intradermal skin testing with articaine in these patients did not indicate an allergic response to articaine (3). Two out of 82 patients, who have had any type of adverse effect of articaine, had a positive skin prick test although no IgE antibodies were found (2).

One woman who received articaine in combination with epinephrine, before a dental extraction, suffered from swelling of her eye and lips. Symtoms decreased after 15 minutes but remained even the day after the procedure (4). Another woman developed itching, redness and papules after local injection of articaine and epinephrine. The rash disappeared within a couple of hours. The patient had tolerated articaine two times before this reaction appeared. Intradermal injection of articaine showed an allergic response in this patient (5).