Protocol for subcutaneous incremental challenge in patients with histories of prior reactions to local anesthetics

* Administered at 20- to 30-minute intervals.
¶ A single-blind, subcutaneous saline step may be inserted before a subcutaneous local anesthetic injection for patients in whom the reaction is suspected to be due to the injection, rather than the drug.
Δ After negative skin testing and a negative saline challenge (step 1), consider proceeding directly to step 4.
◊ The concentration of the local anesthetic (usually 1 to 2%) to be used for the procedure.