Dental treatment of a patient with multiple drug allergies under general anesthesia

Abstract

We performed tooth extraction and dental treatment in a patient with multiple drug allergies. The patient was a 29-year-old female with a past medical history of anaphylaxis to local anesthesia; she also had multiple drug allergies to antimicrobial agents and anti-inflammatory agents. Treatments were performed under general anesthesia without local anesthesia or anti-inflammatory agents, and were completed without an immediate anaphylatic reaction, although vomiting, abdominal pain, diarrhea, and hoarse voice were noted after transfer from the operation room. Intraoperative and postoperative blood pressure and pulse rate were stable, and the eosinophil count, histamine, and C3, C4, and IgE complement levels were normal before and after treatment. The result suggested that performing tests using allergy indices before and after treatment and performing treatment in expectation of possible anaphylatic reaction enable safe dental treatment in patients with multiple drug allergies.