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Reaction to local anaesthetic

dangermouse

Senior Member
Messages
430
This is the second time that I've experienced a reaction to local anaesthetic that was administered by my dentist.

I become drowsy during procedure and afterwards (yesterday) I developed light headedness, severe nausea (still lingering), shakes and tremors. Vision blurred.

The nurse gave me dextrose tablet and on gums. I was tipped back on a bed with a fan on me, I wasn't cold.

After a while I felt that I could sit up (I desperately wanted to go home, I was feeling very ill and didn't want to end up in hospital, I avoid that at all costs) I was still weak and dizzy.

I relapse afterwards and feel very ill.

Has anyone else experienced this kind of reaction to local anaesthetic?
 

Invisible Woman

Senior Member
Messages
1,267
Yes or similar.

If they use a local that contains adrenaline then within a few minutes I will feel very ill, weak and shaky. I'll visibly shake. It used to trigger crashes that lasted a couple of weeks.

I'm guessing the nurse used the dextrose because she thought you were having a sugar low. My understanding is that your body simply can't handle the adrenaline.

It is possible to request an adrenaline free alternative from the dentist. My dentist keeps a supply of it and has written a warning across my notes not to use the usual local.
 

Wonko

Senior Member
Messages
1,467
Location
The other side.
Not precisely.

I know the routine anaesthetic they use for most dental work doesn't work on me, I wasn't aware it could be making things worse. I also know the anaesthetic they use for root canals does work.

I've had root canals were I felt nothing, I've had slice and dice extractions that were pretty bad, nothing compared with TN (TN "taught" me a lot about pain, and how to "handle" it) but still not an experience I'd like to go through every day ;)

I'm always shaky, ill and urgently needing to get home after dental work which has used the routine anaesthetic but I assumed that was normal.

If part of the problem is added adrenaline in the anaesthetic that would make sense, one of the methods I used to help with TN was to medically reduce adrenaline.
 

lafarfelue

Senior Member
Messages
433
Location
Australia
That sounds really scary and awful. I'm glad that you didn't end up in hospital, although that does not at all lessen the severity of your experience and reaction to the drugs at all.

Are you mostly okay now? I hope so and am thinking of you.


I haven't had that reaction to local, but to 'twilight' anaesthetic which was used on me for wisdom teeth surgery.

I have friends who are entirely non-responsive to locals, and 2 friends who respond similarly to you (they are not PwME, but one seems to be borderline MCAS maybe?)... Sorry that I can't recall why they are reactive like that though; what the drugs were and what functions occurred in my friends' systems to react this way.

In the end they end up needing to be put under full anaesthetic for basic stuff (which sucks and can be expensive), but at least they know to avoid locals and scary reactions to them.

Sorry to not be of much help! I just saw this and worried :nervous:
 

dangermouse

Senior Member
Messages
430
If part of the problem is added adrenaline in the anaesthetic that would make sense, one of the methods I used to help with TN was to medically reduce adrenaline.

It does make sense, yes.

Before ME I was never affected by local anaesthesia, I also find it really sedating.
 

Invisible Woman

Senior Member
Messages
1,267
The adrenaline in the locals are useful in that they constrict the local blood vessels which means less bleeding so it's easier for the dentist to see what (s)he is doing.

If there is concern about the possible amount of bleeding another option would be to have the non-adrenaline local, but then if bleeding is an issue to simply squirt some of the adrenaline containing local over the site (not inject). This way it constricts the vessels a bit but you also absorb a lot less.

The vials of non adrenaline local (sorry can't remember the name) are smaller and the product itself is not as long lasting so depending on the procedure you might need a 2nd injection.

Having said that I have had root canals and a dental implant using just the non adrenaline local without trouble.

I haven't had that reaction to local, but to 'twilight' anaesthetic which was used on me for wisdom teeth surgery.

I believe some of these also contain adrenaline and because of the way it isn't "local" your body's reaction might well be magnified. I was offered this for a routine procedure (non dental) and went without because I knew it contained adrenaline. Interestingly, the person trying to talk me into having it was unaware that the product contained adrenaline - I knew because I had looked it up. :nerd:
 

charles shepherd

Senior Member
Messages
2,239
The ME Association has an honorary dental adviser: Dr Richard Cantillon

Dr Cantillon has produced an MEA information leaflet covering all aspects of dental care in relation to ME/CFS:
http://www.meassociation.org.uk/shop/management-leaflets/dental-care

This includes information on the use of adrenaline-free dental anaesthetics (e.g. Citanest) and dental amalgam fillings

Local anaesthetics containing adrenaline need to be used with caution in people who have autonomic nervous system dysfunction - as can occur in ME/CFS

More information on Citanest/adrenaline free dental anaesthetic:
http://www.medsafe.govt.nz/profs/datasheet/c/Citanestwithoctapressininj.pdf

Dr Charles Shepherd
Hon Medical Adviser, MEA
 

ryan31337

Senior Member
Messages
664
Location
South East, England
I know the routine anaesthetic they use for most dental work doesn't work on me, I wasn't aware it could be making things worse. I also know the anaesthetic they use for root canals does work.

Ever been assessed for EDS @Wonko? Lidocaine resistance seems quite well acknowledged as an issue for EDS patients.

I've had countless arguments with Dentists over the years..."But I've given you twice as much as normal you must be numb" etc. It just doesn't kick in until i'm on my way home. I have quite a few other hypermobile traits noted, but I suppose it could just be that I have bad dentists and/or nerves in slightly unusual places. A reasonably successful workaround is an agreement that I have the shots and then go sit in the waiting room for 20 mins....
 

Invisible Woman

Senior Member
Messages
1,267
Interesting @ryan31337.

My sister had the same problem - always needed double doses and still not numb. I think her dentist thought she was a drama queen.

She also was what we used to call "double jointed" in some joints. She was forever on crutches cause she kept going over or twisting her ankles. We always just assumed she was a bit clumsy. This was decades ago..

Now it seems more likely that they are linked. Especially as her daughter was diagnosed with hypermobility.
 

Binkie4

Senior Member
Messages
644
@dangermouse

I hope you are feeling much better.
Just writing to say that I cannot tolerate adrenaline for dental anaesthesia either. My dentist was very helpful when I told her of my reaction and substituted a non adrenaline type. It gives good results and I no longer get the collapse feeling which used to occur.
I have had extensive treatment with no further problems. ( I can almost never say that so a great relief).
Out of interest, I have just been diagnosed with hyper mobility issues.
 

Wonko

Senior Member
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1,467
Location
The other side.
Ever been assessed for EDS @Wonko? Lidocaine resistance seems quite well acknowledged as an issue for EDS patients.
I've looked at EDS before and just re-checked. From a non doctor perspective I don't seem t meet the criteria, as far as I know my joints aren't hyper mobile, when I was more active I used to frequently twist/break ankles for no apparent reason (now I don't walk anywhere so it doesn't happen) but as far as I can see that's just another "weird", it doesn't fit into EDS.

I've been through the wait 20minutes, have another shot etc. with several dentists (I've even had wait 20 minutes, have another shot, next person done, is it working yet, no, but get on with it), waiting might work for some but if the anaesthetic doesn't work with me it doesn't work, if it's the type that does it's fine within a couple of minutes.
 

JaimeS

Senior Member
Messages
3,408
Location
Silicon Valley, CA
Wow, had no idea any of this is related. Old anesthetic, my childhood dentist just didn't believe me when I said I was still in pain. I figured I just had to deal with it. I had awful cavities as a child (which I later learned was probably because of my low IgA) even though my teeth were straight.

Fast-forward to the dentist I used as an adult, who didn't use lidocaine but some other numbing agent the first time there was an issue. Cue me, white-knuckled on the chair and... oh, that's slightly uncomfortable but... that's... wait, you're done?!

I definitely have hypermobility traits, and first dx on experiencing CFS-type symptoms was 'benign joint hypermobility disorder'.

Still, after dental work, I'd get the chills and flushes of heat, and anything that lasted longer than 20 or 30 minutes required someone else to give me a ride home. Like one of the other posters, I just figured this was normal, or at least that it had no real connection to ME/CFS.

Hmm.

[Edit: should add that mother, who also has CFS but is not hypermobile, has same issues.]
 
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lafarfelue

Senior Member
Messages
433
Location
Australia
I believe some of these also contain adrenaline and because of the way it isn't "local" your body's reaction might well be magnified. I was offered this for a routine procedure (non dental) and went without because I knew it contained adrenaline. Interestingly, the person trying to talk me into having it was unaware that the product contained adrenaline - I knew because I had looked it up. :nerd:

This is really interesting. Thanks for sharing this information, it'll be really useful for when I need to go back to the dentist soon.

I had my wisdom teeth out 20 years ago, before any obvious symptoms of ME/CFS emerged. I wonder if it's related to my hyper mobility, if I've had low lying 'whatever this is' for a lot of my life...? Good grief these kinds of things raise so many questions for me. :confused:
 

IreneF

Senior Member
Messages
1,552
Location
San Francisco
I have problems with dental anesthesia. I've had reactions to epinephrine (adrenalin) all my life, so my dentist knows not to use it. I also had red hair before it went gray, and redheads need more anesthetic. My dentist is very patient.

Last time I had dental work I asked for gas (nitrous). It was great. I just didn't care about what was going on in my mouth and I got back to my regular self within a few moments after the gas was turned off.
 

dangermouse

Senior Member
Messages
430
@dangermouse

I hope you are feeling much better.
Just writing to say that I cannot tolerate adrenaline for dental anaesthesia either. My dentist was very helpful when I told her of my reaction and substituted a non adrenaline type. It gives good results and I no longer get the collapse feeling which used to occur.
I have had extensive treatment with no further problems. ( I can almost never say that so a great relief).
Out of interest, I have just been diagnosed with hyper mobility issues.

I'm feeling much better now, thanks. It wasn't nice.

I'm going ask for the non adrenaline option if/when I need a local anaesthetic again. Thanks for that information.

That's interesting that you've just been diagnosed with hyper mobility issues.