Adverse Effects of Local Anesthetics in Their Clinical Use

Medications that cause local anesthesia are widely used in surgical and dental practice. Depending on the chemical structure modern anesthetics are divided into derivatives of amides (lidocaine, trimecain, mepivacaine, articaine, etc.) and ester derivatives of para-aminobenzoic acid (procaine, dicaine, and benzocaine). Adverse reactions when using this group of drugs are quite common, predictable and can be serious, life-threatening or even fatal. 72 cases of adverse reactions to local anesthetics which took place in Ivano-Frankivsk region from 2007 to 2014 and registered by the Regional Office of the State Expert Center Ministry of Health of Ukraine (SEC) by spontaneous reports of doctors (form № 137) were analyzed. The most common serious adverse reactions occurred when using articaine and preparations containing it (62.5% of cases including 1 fatal case due to anaphylaxis), allergic reactions of varying severity were prevalent when administering novocaine (10%), adverse reactions to lidocaine and bupivacaine took place in 11.5% and 12.5% of cases respectively, and allergic reactions to mepivacaine were found in 2.5% of these cases. The recorded adverse reactions (AR) to anesthetics required pharmacological correction using two or more drugs (82%), hospitalization (46%) or prolongation of hospitalization on average for 2 days (36%). Lethal outcome after using of articaine was caused by an anaphylactic shock in patient with burdened allergic history (bronchial asthma).