Adverse drug reactions of local anesthetics used in dentistry

Matveev A.V.; Krasheninnikov A.E.; Yagudina R.I.; Egorova E.A.; Konyaeva E.I.

doi:https://doi.org/10.17116/stomat20209906182

Matveev A.V.

National Pharmacovigilance Research Center;
Medical Academy n. a. S.I. Georgievsky of Vernadskjy CFU, Simferopol

Krasheninnikov A.E.

National Pharmacovigilance Research Center

Yagudina R.I.

I.M. Sechenov First Moscow State Medical University

Egorova E.A.

Medical Academy n. a. S.I. Georgievsky of Vernadskjy CFU, Simferopol

Konyaeva E.I.

Medical Academy n. a. S.I. Georgievsky of Vernadskjy CFU, Simferopol

Adverse drug reactions of local anesthetics used in dentistry

Authors:

Matveev A.V., Krasheninnikov A.E., Yagudina R.I., Egorova E.A., Konyaeva E.I.

More about the authors

Journal: Stomatology. 2020;99(6): 82‑88

DOI: 10.17116/stomat20209906182

Read: 7285 times

Download PDF (RU)

Contact the author

Table of contents

To cite this article:

Matveev AV, Krasheninnikov AE, Yagudina RI, Egorova EA, Konyaeva EI. Adverse drug reactions of local anesthetics used in dentistry. Stomatology. 2020;99(6):82‑88. (In Russ.)
https://doi.org/10.17116/stomat20209906182

Подписка 2026 Стоматология (Stomatology)

Использование инфографики авторами научных работ

Close metadata

MATERIAL AND METHODS

The objects of the study were 122 notification forms about LA ADR recorded in the regional base (Register) of spontaneous reports called ARCADe (Adverse Reactions in Crimea, Autonomic Database). In most cases, ADR was associated with the use of amide LA Lidocaine — 69 cases (56.55% of the total number of cases for LA ADR), less often, ADR was caused by combinations containing Articaine (34 cases, 27.87%). Rare cases of ADR were reported for Novocaine/Procaine (9 cases, 7.38%), Bupivacaine (8 cases, 6.56%) and Mepivacaine (2 cases, 1.64%). The main clinical manifestations of reactions were hypersensitivity-like reactions (38 cases), cardiac and vascular disorders (29 cases) and central nervous system disorders (19 cases). Lack of effectiveness of LA occurred in 13 cases (10.66%).

RESULTS

A study of the outcome of ADR revealed a high incidence of life-threatening conditions associated with LA use — 31 cases (25.4%), which indicates the severity of the event and the need to cancel the suspected drug and prescribe additional medications for correction. The need for hospitalization or prolongation of hospitalization was necessary in 7 cases (5.8%), and temporary disability of patients was revealed in 5 cases (4.1%). Of particular interest are 2 cases (1.6%) of the development of a fatal outcome as a result of the suspected anaphylactic shock (1 case) and disorders of the central nervous system (convulsions, development of respiratory failure).

CONCLUSION

The high frequency and severity of unwanted effects resulted from the use of LA requires healthcare professionals to make rational choices and strictly monitor patient safety.

Keywords:

local anesthetics

adverse reactions

Authors:

Matveev A.V.

National Pharmacovigilance Research Center;
Medical Academy n. a. S.I. Georgievsky of Vernadskjy CFU, Simferopol

Krasheninnikov A.E.

National Pharmacovigilance Research Center

Yagudina R.I.

I.M. Sechenov First Moscow State Medical University

Egorova E.A.

Medical Academy n. a. S.I. Georgievsky of Vernadskjy CFU, Simferopol

Konyaeva E.I.

Medical Academy n. a. S.I. Georgievsky of Vernadskjy CFU, Simferopol

Received:

24.09.2019

Accepted:

09.10.2019

Close metadata

References:

Ovechkin AM. Clinical pharmacology of local anesthetics: classical concepts and new perspectives of applying in intensive therapy. Regional’naya anesteziya i lechenie ostroi boli. 2013;7(3):6-15. (In Russ.).
Karpuk IYu. Allergic reactions to local anesthetics: diagnosis and prevention. Vestnik VGMU. 2009;8(3):15-18. (In Russ.).
Peredkova YeV. Local anestethics in tolerance. How to prevent. Effektivnaya farmakoterapiya. Allergologiya i immunologiya. 2013;1: 4-51. (In Russ.).
Luss LV. Problems of diagnostics and prevention of a medicinal allergy to local anesthetic drugs. Allergologiya, immunologiya, pul’monologiya. 2009; 3(35):32-36. (In Russ.).
Macharadze DSh. Allergy to local anesthetics. Lechashchii vrach. 2015;7:66. (In Russ.).
Lebedev KA, Ponyakina ID, Mitronin AV, Sagan LG, Gorchakov ME, Godunova MI. Allergic reactions to local anesthetics and methods for their diagnosis. Stomatologiya dlya vsekh. 2005;3:16-22. (In Russ.).
Karpuk IYu, Novikov PD, Zakharova OV. Anaphylaxis to novocaine and drugs used in complex premedication. Immunopatologiya, allergologiya, infektologiya. 2009;4:62-67. (In Russ.).
Spravochnik lekarstvennykh preparatov Vidal’. (In Russ.). https://www.vidal.ru/
Federal’nyizakonRossiiskoiFederatsii №61-FZ ot 12 aprelya 2010 g. «Ob obrashchenii lekarstvennykh sredstv». (In Russ.). https://www.consultant.ru/document/cons_doc_LAW_99350/
Uppsala Monitoring Centre. The use of theWHO-UMC system for standardised case causality assessment. Accessed September 10, 2019. https://www.who.int/medicines/areas/quality_safety/safety_efficacy/WHOcausality_assessment.pdf
Stephens’ Detection and Evaluation of Adverse Drug Reactions: Principles and Practice. John Wiley & Sons, Ltd.; 2011.
Hartwig SC, Denger SD, Schneider PJ. Severity-indexed, incident report-based medication error-reporting program. Am J Hosp Pharm. 1991;48: 2611-2616.
Classen DC, Pestotnik SL, Evans RS, Lloyd JF, Burke JP. Adverse drug events in hospitalized patients. Excess length of stay, extra costs, and attributable mortality. JAMA. 1997;277:301-306.
Grzanka A, Wasilewska I, Sliwczynska M, Misiolek H. Hypersensitivity lo local anesthetics. Anaesthesiol Intensive Ther. 2016;48(2):128-134. https://doi.org/10.5603/AIT.a2016.0017
Malinovsky JM, Chiriac AM, Tacquard C, Mertes PM, Demoly P. Allergy to local anesthetics: Reality or myth? La Presse Médicale. 2016;45(9): 753-757. https://doi.org/10.1016/j.lpm.2016.05.011
Allen G, Chan D, Gue S. Investigation and Diagnosis of an Immediate Allergy to Amide Local Anaesthetic in a Paediatric Dental Patient. Australian Dental J. 2017;62(2):241-245. https://doi.org/10.1111/adj.12501
Kaidashev I, Digtiar N, Mormol I, Demidenko O, Granovskaya G et al. Presentation and Management of Local Anesthetic Hypersensitivity in Ukraine. J Allergy Clin Immunol. 2017;139(2):AB41. https://doi.org/10.1016/j.jaci.2016.12.190
Rakhmatullina NM, Akhmedzyanova DG, Sibgatullina NA. The place of acute hypersensitivity drug reactions when using local anestheticsin multidisciplinary clinic setting. Vestnik sovremennoi klinicheskoi meditsiny. 2018; 11(5):115-118. (In Russ.). https://doi.org/10.20969/vskm.2018.11(5).115-118
Kuzin AV, Shafranskii AP, Izmailova ZM, Remizov GV. Dental care for patients at risk of adverse reactions to local anesthetics. Stomatologiya. 2018; 97(6):63-66. (In Russ.). https://doi.org/10.17116/stomat20189706163
Rabinovich SA, Zavodilenko LA. Sistemnaia toksichnost’ mestnykh anestetikov. Systemic toxicity of local anesthetics. Stomatologiia (Mosk). 2017;96(2): 36-42. https://doi.org/10.17116/stomat201796236-42. (In Russ.).