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Anesthesia · single question

A patient is allergic to lidocaine (an amide local anesthetic). Which alternative local anesthetic is most appropriate?

  1. An ester-class anesthetic (e.g., a preservative-free agent) or an amide from a different group after allergy evaluation
  2. Pilocarpine
  3. Atropine
  4. Epinephrine alone
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Correct answer: A. An ester-class anesthetic (e.g., a preservative-free agent) or an amide from a different group after allergy evaluation

True amide allergy is rare; management involves selecting an anesthetic from a different chemical class (ester vs amide) and avoiding cross-reacting preservatives, ideally after allergy testing. Among the options, choosing a different-class anesthetic is correct.Other options: Pilocarpine and atropine are not local anesthetics; epinephrine is a vasoconstrictor, not an anesthetic.Key exam takeaway: Local anesthetic allergy: switch chemical class (ester vs amide), avoid offending preservatives, and consider allergy testing.

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