{"id":60337,"date":"2024-08-09T14:18:29","date_gmt":"2024-08-09T11:18:29","guid":{"rendered":"https:\/\/www.synevo.md\/?post_type=product&#038;p=60337"},"modified":"2026-02-19T00:32:52","modified_gmt":"2026-02-18T22:32:52","slug":"lidocain-ige-specific","status":"publish","type":"product","link":"https:\/\/old.synevo.md\/ru\/shop\/lidocain-ige-specific\/","title":{"rendered":"\u0410\u043b\u043b\u0435\u0440\u0433\u0435\u043d \u041b\u0438\u0434\u043e\u043a\u0430\u0438\u043d\/\u041a\u0441\u0438\u043b\u043e\u043a\u0430\u0438\u043d, \u0441\u043f\u0435\u0446\u0438\u0444\u0438\u0447\u0435\u0441\u043a\u0438\u0439 IgE"},"content":{"rendered":"<p>Alergia la anestezicele locale este o hipersensibilitate la medicamentele utilizate pentru anestezia local\u0103 \u00een chirurgie general\u0103, stomatologie, neurologie, ginecologie \u0219i oftalmologie. Procesul patologic poate ap\u0103rea sub forma unei reac\u021bii alergice \u0219i pseudo-alergice. Manifest\u0103rile clinice se caracterizeaz\u0103 prin dezvoltarea urticariei, dermatitei, edemului Quincke, anafilaxiei \u0219i bronhospasm.<\/p>\n<p>Adev\u0103ratele reac\u021bii alergice la administrarea unui anestezic sunt rare, procesul patologic are loc prin mecanismul pseudoalergiei. Hipersensibilitatea se dezvolt\u0103 adesea la anestezicele locale, structur\u0103 chimic\u0103 c\u0103ror con\u021bine esterii acidului benzoic (novocain\u0103, tetracain\u0103, benzocain\u0103), mai rar la medicamentele care con\u021bin amid\u0103 (lidocain\u0103, trimecain\u0103, articain\u0103 etc.). Conform statisticilor, reac\u021biile alergice \u0219i pseudoalergice asociate cu utilizarea anestezicelor locale reprezint\u0103 de la 6 p\u00e2n\u0103 la 20% din toate cazurile de alergii la medicamente.<\/p>\n<p>Anestezicele locale sunt utilizate pe scar\u0103 larg\u0103 \u00een diverse ramuri ale practicii medicale, \u00een primul r\u00e2nd \u00een chirurgia ambulatorie, stomatologie, oftalmologie, ginecologie, neurologie \u0219i endoscopie. Anestezicele locale sunt disponibili sub form\u0103 de solu\u021bie injectabil\u0103 (Lidocaina, Septanest, Scandonest, Bupivacain), pic\u0103turi pentru ochi \u0219i urechi (Otirelax, Otipax\u00ae, Dropleks) spr\u0103iuri (Lysobact Complete Spray\u00ae, Lidocain, Duoseptol\u00ae)\u00a0 sau geluri (Dentinox-Gel N, Lidbree\u00ae).<\/p>\n<p>Reac\u021biile alergice la anestezicele locale includ dou\u0103 tipuri de reac\u021bii: reac\u021bii de tip I mediate de imunoglobulin\u0103 E (IgE) \u0219i reac\u021bii de tip IV mediate de celule-T. Primele apar \u00een decurs de 1-4 ore. R\u0103spunsul de tip IV este mediat de celulele-T care sunt expuse la antigene exprimate de celulele Langerhans, iar r\u0103spunsul are loc atunci c\u00e2nd celulele T de memorie sensibilizate sunt din nou expuse la aceia\u0219i antigene. Acest lucru dureaz\u0103 de obicei 24-72 de ore, dar pot ap\u0103rea \u00een decurs de 2 ore \u00een unele cazuri. Rea\u021bii de tip IgE este tipul de reactie ce poate avea potential de severitate pana la socul anafilactic. Aceste tipuri de alergii pot fi investigate prin testare cutanata sau prin determinarea in sange a anticorpilor specifici din clasa E de imunoglobuline.<\/p>\n<p><strong>Lidocaina. <\/strong>Denumiri comerciale: Xilina, Lignospan,Lignospan forte, Xylestesin-A. Pentru anestezia topic\u0103: spray Lidocain, Topicain, Dicagel, Ziagel. Lidocaina este un medicament amidic utilizat pentru anestezia local\u0103 \u0219i regional\u0103 \u0219i, de asemenea, ca agent antiaritmic. Lidocaina a fost introdus\u0103 \u00een practica chirurgical\u0103 \u00een anul 1948, \u00eenlocuid procaina (Novocaina). Disponibil sub form\u0103 de solu\u021bie injectabil\u0103, pic\u0103turi pentru ochi, spray sau gel. Lidocaina ac\u021bioneaz\u0103 mai intens \u0219i dureaz\u0103 mai mult (p\u00e2n\u0103 la 75 de minute) dec\u00e2t novocaina, dar durata sa de ac\u021biune este mai scurt\u0103 dec\u00e2t cea a bupivacainei. C\u00e2nd epinefrina este ad\u0103ugat\u0103 la lidocain\u0103, efectul anestezic cre\u0219te la 2 ore. Poate fi utilizat pentru toate tipurile de anestezie local\u0103. Medicamentul poate fi administrat parenteral, aplicat cu spray-uri sau sub form\u0103 de pl\u0103ci pentru sindromul dureresc din cauza leziunilor vertebrogene, miozitei, nevralgiilor postherpetice. \u00cen cardiologie, lidocaina se administreaz\u0103 intravenos \u0219i este utilizat\u0103 pentru ameliorarea paroxismelor tahicardiei ventriculare \u0219i a aritmiilor ventriculare, inclusiv \u00een timpul infarctului miocardic \u0219i a interven\u021biilor chirurgicale pe inim\u0103.<\/p>\n<p>La fel ca marea majoritate a medicamentelor, lidocaina poate avea efecte secundare asupra diferitelor organe \u0219i sisteme, de exemplu sub form\u0103 de sc\u0103dere a tensiunii arteriale, dureri de cap, grea\u021b\u0103, v\u0103rs\u0103turi, stop respirator, confuzie, methemoglobinemie, precum \u0219i reac\u021bii alergice \u0219i \u0219oc anafilactic. Reac\u021biile alergice imediate la lidocain\u0103 includ urticaria, umflarea la locul inject\u0103rii, bronhospasmul \u0219i \u0219ocul anafilactic. C\u00e2nd se aplic\u0103 medicamentul pe piele, este posibil\u0103 urticaria de contact. Reac\u021biile \u00eent\u00e2rziate includ eczeme locale sau r\u0103sp\u00e2ndite, eritem pigmentar fixat. Reac\u021bii alergice \u00eencruci\u0219ate \u00eentre lidocain\u0103 \u0219i alte anestezice amidice nu sunt \u00een prezent observate.<\/p>\n<p>\u00cen cazurile suspiciunii de alergii la un anestezic local, se efectueaz\u0103 testarea pentru a determina prezen\u021ba imunoglobulinelor specifice de clasa E.<\/p>\n<p><strong>Preg\u0103tire pacient<\/strong> \u2013 \u00e0 jeun (pe nem\u00e2ncate) sau postprandial (dup\u0103 mese).<\/p>\n<p><strong>Specimen recoltat<\/strong> -s\u00e2nge venos.<\/p>\n<p><strong>Recipient de recoltare<\/strong> \u2013 vacutainer f\u0103r\u0103 anticoagulant cu\/ f\u0103r\u0103 gel separator.<\/p>\n<p><strong>Prelucrare necesar\u0103 dup\u0103 recoltare<\/strong> \u2013 se separ\u0103 serul prin centrifugare.<\/p>\n<p><strong>Volum prob\u0103 <\/strong>\u2013 minim 0.5 mL ser.<\/p>\n<p><strong>Stabilitate prob\u0103 <\/strong>\u2013 serul separat este stabil 2 zile (48 ore) la 2-8\u00b0C; 2 luni la -20\u00b0C.<\/p>\n<p><strong>Cauze de respingerea a probei:<\/strong> specimen intens hemolizat sau care nu a fost p\u0103strat \u00een condi\u021bii optime.<\/p>\n<p><strong>Metoda<\/strong> \u2013 ELISA.<\/p>\n<p><strong><em>Recomand\u0103ri pentru efectuarea testului:<\/em><\/strong><\/p>\n<ul>\n<li>imposibilitatea efectu\u0103rii unui test cutanat datorit\u0103 pericolului unei reac\u0163ii anafilactice;<\/li>\n<li>\u00een cazul suspiciunii clinice de alergie de tip imediat, de\u015fi Ig E specifice \u015fi testul cutanat sunt negative.<\/li>\n<\/ul>\n<p><strong>Raportarea \u0219i interpretarea rezultatelor:<\/strong><\/p>\n<p><em>Pozitiv<\/em> &#8211; sensibilizare de tip I\u00a0 la medicament testat.<\/p>\n<p><em>Negativ <\/em>&#8211; nu exist\u0103 sensibilizare de tip imediat fa\u0163\u0103 de preparatul testat.; restric\u021bionarea sau excluderea pe termen lung a contactului cu alergenul.<\/p>\n<p><strong><em>Atentie!<\/em><\/strong> Acest test determin\u0103 prezen\u021ba imunoglobulinelor E specifice c\u0103tre unui anumit anestezic \u0219i determin\u0103 doar posibila dezvoltare\u00a0 reac\u021biei alergice de tip 1, adic\u0103 de hipersensibilitate imediat\u0103. \u00cen plus produc\u021bia de imunoglobuline specifice E are loc dup\u0103 administrarea ini\u021bial\u0103 \u0219i manifestarea clinic\u0103 a reac\u021biilor alergice apare doar la administrare repetat\u0103 alergenului (perioada de sensibilizare).<\/p>\n<p><strong><em><span style=\"text-decoration: underline;\">\u0411\u0438\u0431\u043b\u0438\u043e\u0433\u0440\u0430\u0444\u0438\u044f:<\/span> <\/em><\/strong><\/p>\n<p>Anestezia loco-regional\u0103 \u00een stomatologie \u0219i chirurgia OMF. Nicolae Chele, Gabriela Motelica.<\/p>\n<p>\u0421\u043f\u0440\u0430\u0432\u043e\u0447\u043d\u0438\u043a \u043b\u0435\u043a\u0430\u0440\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0445 \u0441\u0440\u0435\u0434\u0441\u0442\u0432 VIDAL.<\/p>\n<p>Nomenclatorul de stat al medicamentelor. https:\/\/amdm.gov.md\/ro\/page\/nomenclatorul_de_stat_amed<\/p>","protected":false},"excerpt":{"rendered":"<p>\u041b\u0438\u0434\u043e\u043a\u0430\u0438\u043d \u2013 \u043b\u0435\u043a\u0430\u0440\u0441\u0442\u0432\u0435\u043d\u043d\u044b\u0439 \u043f\u0440\u0435\u043f\u0430\u0440\u0430\u0442 \u0430\u043c\u0438\u0434\u043d\u043e\u0433\u043e \u0440\u044f\u0434\u0430, \u043f\u0440\u0438\u043c\u0435\u043d\u044f\u0435\u043c\u044b\u0439 \u0434\u043b\u044f \u043c\u0435\u0441\u0442\u043d\u043e\u0439 \u0438 \u0440\u0435\u0433\u0438\u043e\u043d\u0430\u043b\u044c\u043d\u043e\u0439 \u0430\u043d\u0435\u0441\u0442\u0435\u0437\u0438\u0438, \u0430 \u0442\u0430\u043a\u0436\u0435 \u0432 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