What are the treatment options for allergic reactions in local anesthetic toxicity?

Updated: Jan 09, 2019
  • Author: Raffi Kapitanyan, MD; Chief Editor: David Vearrier, MD, MPH  more...
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Although allergic reactions to local anesthetics are extremely rare, these are treated according to severity. Mild cutaneous reactions may be treated with oral or intravenous (IV) diphenhydramine (Benadryl, 25-50 mg for adults, 1 mg/kg for pediatric patients).

For more serious allergic reactions, administer subcutaneous epinephrine (0.3 mL of 1:1000 dilution) and closely monitor for further decompensation. Corticosteroids (125 mg methylprednisolone IV push, or 60 mg prednisone orally) should be given to the patient with severe allergic reactions (eg, respiratory distress, hypotension).

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