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PubMed1987

Allergy to local anesthetics: comparison of patch test with prick and intradermal test results.

The interrelation between immediate and delayed hypersensitivity reactions to local anesthetics is poorly understood. Especially, the relevance of positive patch test reactions to local anesthetics with regard to the compatibility of injected local anesthetics is unclear. We therefore subjected 104 patch test-positive probands to prick and intradermal tests with seven local anesthetic agents. All prick tests were negative. Only 14 patients showed positive reactions in intradermal tests: 11 with the ester local anesthetic procaine, one with the amide local anesthetic butanilicaine, and two with both. Procaine yielded both immediate and delayed reactions; butanilicaine, only immediate reactions. All other local anesthetics showed negative reactions. It is concluded that in patients with positive patch test reactions to local anesthetics and negative history of anaphylactoid reactions, positive skin test reactions to intradermal application are rare and that, therefore, the risk of anaphylactic reactions to injection anesthesia with amide local anesthetics, except butanilicaine, appears low in these patients.

Adult↗
PubMed1995

The effect of cocaine and other local anesthetics on central dopaminergic neurotransmission.

The effects of cocaine on dopaminergic function in the rat were compared with those of other local anesthetics having an esteratic linkage (dimethocaine, procaine) or an amide linkage (lidocaine). By means of reverse-phase HPLC with electrochemical detection and gas chromatography-mass spectrometry, levels of dopamine (DA) and its metabolites 3-methoxytyramine (3-MT) and dihydroxyphenylacetic acid were quantified in the striatum, nucleus accumbens and prefrontal cortex after i.p. injection of the drugs or saline. Time course and dose response studies determined the effects of the drugs on these parameters of dopaminergic function. These studies provide strong evidence that the three esteratic local anesthetics cocaine, dimethocaine and procaine all increase the synaptic presence of DA, as reflected in increased levels of 3-MT and the ratio of 3-MT to DA, in the striatum, nucleus accumbens and prefrontal cortex. Surprisingly, procaine had an equal or greater effect than cocaine and dimethocaine on 3-MT levels and the ratio 3-MT/DA. The effects of these drugs on dihydroxyphenylacetic acid, an indicator of intraneuronal metabolism of DA, were more variable. However, the amidergic local anesthetic lidocaine did not affect DA metabolism. Although the exact mechanisms behind the dopaminergic activities of procaine and dimethocaine remain unknown, it is clear that these drugs, as well as cocaine, activate dopaminergic systems in the intact animal.

3,4-Dihydroxyphenylacetic Acid↗
PubMedDate not supplied

Local anaesthetic activity of some sec-amino-N-(aryl-aralkyl)-ethyl acetamides.

Six basic amides were screened for local anaesthetic activity and compared with procaine and lignocaine. Amongst the basic amides screened, piperidino-N-(alpha-4-ethoxy phenyl- beta-phenyl) ethyl and Diethylamino-N (alpha-4-ethoxy- beta-phenyl) ethyl acetamide were found to be more effective as compared to lignocaine. They were found to be non-irritant, and non-toxic even in high doses.

Acetamides↗
PubMed1980

Allergic hypersensitivity to lidocaine hydrochloride.

A 39-year-old man developed allergic hypersensitivity to lidocaine hydrochloride and showed urticarial dermographism. Although hypersensitivity reactions to local anesthetics are rare and are usually due to esters of procaine, reaction to the amides of lidocaine can occur. A review of the literature for the past decade revealed only four reported cases of allergic hypersensitivity to lidocaine hydrochloride.

Adolescent↗