Assessment of allergy to local anesthetic.

A 57-year-old woman with a history of allergy to local anesthetics was referred to us to be admitted for a general anesthetic for removal of a sliver from her finger. Because allergic reaction to local anesthetics often is caused by an anesthetic other than lidocaine, or is due to the carrier vehicle in the diluent, a skin test with pure lidocaine was performed. After showing no reaction, the patient was given the standard dose of lidocaine and the sliver was removed in the emergency department. The patient was discharged home with no sequelae.