Which anesthetic is known to cause the highest rate of allergic reactions?

Benzocaine is known for having a higher rate of allergic reactions compared to other local anesthetics. It is a topical anesthetic that belongs to the ester group and is often used for its fast-acting properties in providing surface anesthesia. The reason allergenic responses can be more prominent with benzocaine is largely due to its metabolic byproducts and the chemical structure of esters, which can lead to sensitization in some individuals.

In contrast, Lidocaine, Articaine, and Mepivacaine are amid-type local anesthetics. They are typically less likely to provoke allergic reactions because amides are metabolized differently, causing fewer allergic responses. While it is still possible for individuals to react to these drugs, the incidence is generally much lower than that observed with benzocaine, making benzocaine stand out as the anesthetic associated with a higher risk of allergic reactions.