sábado, 14 de junio de 2014

Anafilaxis en dental/Dental anaphylaxis

Shock anafilactico en clínica dental 
Anaphylactic shock management in dental clinics: An overview.  
Nanavati RS, Kumar M, Modi TG, Kale H.  
J Int Clin Dent Res Organ [serial online] 2013 [cited 2014 Jun 9];5:36-9.  
Introduction 
Anaphylaxis is defined as "an acute, potentially life-threatening hypersensitivity reaction, involving the release of mediators from mast-cells, basophils and recruited inflammatory cells. Anaphylaxis is defined by a number of signs and symptoms, alone or in combination, which occur within minutes, or up to a few hours, after exposure to a provoking agent. It can be mild, moderate to severe, or severe. Most cases are mild but any anaphylaxis has the potential to become life-threatening" (World Allergy Organization). Anaphylaxis develops rapidly, usually reaching peak severity within 5-30 min, and may, rarely, last for several days. All dental practitioners should be aware of the diagnosis and management of emergencies such as anaphylaxis that may arise from the use of local anesthetic agents in their clinical set up. Resuscitative drugs such as antihistamine, adrenaline and corticosteroids should be available at chair side for immediate use. All patients must be warned prior to local anesthetic age nt administration of the possible danger that follows its use. They should be told to report back immediately to the clinic if a rash should develop. [1] Anaphylaxis may develop immediately and is usually immediately life-threatening due to respiratory embarrassment. Early symptoms and signs include a sensation of warmth, itching especially in the axilla and groin, and a feeling of anxiety and panic. These may progress into an erythematous or urticarial rash, edema of the face and neck, bronchospasm and laryngeal edema 

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