Cardiac catheterization in the patient with history of allergy to local anesthetics.

Patients with a history of allergic reactions to local anesthetic drugs present a difficult problem during evaluation for cardiac catheterization procedures. In the worst cases the procedure may be deferred, or even performed without local anesthesia. In the vast majority of patients an acceptable agent for safe local anesthetic use can be found. Skin testing beginning with very dilute solutions of preservative-free local anesthetic agent may be administered easily. This report describes the practical aspects of skin testing and local anesthetic agent selection in patients with a history of allergic reaction to local anesthetic drugs.