Reaction to local anaesthetic

[welshbabe]

Hi all - had dental extractions in hosp on Wednesday as my NHS dentist scared to touch me. I always have the non-adrenaline ones but have been feeling awful with aches and weakness ever since - so that's no guarantee to feel ok afterwards.

 

[Binkie4]

Sorry @welshbabe that you are still having problems with dental anaesthesia. Sounds quite dramatic to have to have treatment in hospital.

I had a root canal 10 days ago with non adrenaline anaesthesia. Spent an hour and a half in dental chair today having impressions etc for a bridge. I think my dentist is worthher weight in gold to me. No pain and no shakiness, clamminess so long as I don't have adrenaline.

Good luck with your next treatment.

 

[Diwi9]

Just posted the below in another thread, but will document here if anyone searches this subject.

I have problems getting numbed at the dentist, especially in my lower mandible. One time I had four different types of injections, including what the dentist referred to as "old school"...she could not numb a particular nerve. During my wisdom teeth removal, the anesthesia wore off during the last tooth extraction. During a root canal of an upper molar, I was unable to get numbed, the endodontist could not believe it after giving me multiple injections. My current dentist is certified in IV sedation and I pay extra for it so that I do not have to experience so much pain.

 

[joejack102]

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?

"Local or regional anesthesia involves the injection or application of an anesthetic drug to a specific area of the body, as opposed to the entire body and brain as occurs during general anesthesia."

Are you SURE this was localized anesthetic? Usually "local anesthetic" refers to lidocaine that only affects a specific spot on the body/skin. Sounds like you had general anesthetic drugs...

 

[bertiedog]

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

In the late 70s I actually went blind following a dental injection for a filling. It was terrifying. Gradually it went into a vertigo attack that shook me up to the degree I am still phobic about every single dental injection I have. Ever since that day I never have adrenaline in any injection but always remind the dentist that this is the case. He is a lovely guy and we laugh about it but I still have to check!

I know I overproduce adrenaline and I have taken a very low dose of Propananol since the late 90s and every time I take it it always makes me feel a touch better somehow. I do have adrenals that no longer function without a steroid and I am pretty sure my adrenals were in a bad way even in the late 70s so I do fit the picture of someone who has autonomic issues.

Pam

 

[Strawberry]

Wow, I have to remember this! I don't numb, and I have hypermobility/EDS...

My mom has made sure since I was a little kid that the anesthetist knew there was a family allergy, so I have always had "safe" anesthetics. But locals don't numb me!

 

[welshbabe]

Sorry @welshbabe that you are still having problems with dental anaesthesia. Sounds quite dramatic to have to have treatment in hospital.

Good luck with your next treatment.

I had it done in hospital as I was 'foolish' enough to tell my dentist I am not well after injections - he took it to mean I would be ill in the chair - but for me its days afterwards.

I also always remind them about the non-adrenaline - but once before I had real bad heads and dizzy as described above by Dangermouse, even with no adrenaline - went on for weeks. Went to my Doctor who said the chemicals would have been out of my system in under a day and back to the dentist in tears to be pretty much told the same thing. However I know how it made me feel - no matter what they said.

Luckily (!) I've not had the bad heads and dizziness this time - just complete muscle aches and weakness like the flu.

 

[KIO]

Hello everybody! My experience:
- from the dentist's anesthesia, even without adrenaline, I always go vaguely drunk.
- I did the tests for allergies to local anesthetic: I am allergic only to the articinaine.
- Two days ago, they made me 3 local anesthesia, lidocaine (for skin sampling) ... in the end I had to sign some documents. I could not converge my eyes, my hands were shaking, I talked too much, and I was totally drunk.
Yesterday ALL muscles hurt, similar to when you exceed the limits in ME, but really much worse.
Today is almost past, and I'm almost fine. Had it been the usual exhaustion after exertion, today I could not move.
I struggle not to think about lidocaine.

 

[TinaYesen]

I had a dental procedure today with local anesthetic, what I assumed was Lidocaine. Almost immediately I had intense tremors in my arms and right leg and felt a surge of terror which made no sense, my blood pressure shot up from 110/68 to 148/100.

I cried I was so terrified what was happening as my body was jerking all around in the chair.

I've never had this reaction my whole life until getting ME last year, so I'm certain this new sensitivity is due to my ME.

Thank you for posting this chain, as now I know to ask my dentist to not use epinephrine. That was very scary.

 

[Gingergrrl]

I had a dental procedure today with local anesthetic, what I assumed was Lidocaine. Almost immediately I had intense tremors in my arms and right leg and felt a surge of terror which made no sense, my blood pressure shot up from 110/68 to 148/100.

I am so sorry this happened to you! Do you know if the lidocaine contained Epinephrine (Adrenaline)? If so, that would be my first guess as to what triggered your reaction and that it was due to the Epi vs. lidocaine. But it is also possible that you had an allergic reaction to the lidocaine itself.

For people w/a history of MCAS & POTS (like myself), I am supposed to use Mepivocaine without Epi (and without dyes) for dental work. I've been postponing dental work since 2017 due to the fear of being allergic to the ingredients used in the dental fillings (but this is another story )

 

[Davsey27]

Sorry to hear you went through this.

This is one of my concerns as well.As it was suggested I have a tooth extracted and feeling a bit concerned.

 

[TinaYesen]

I am so sorry this happened to you! Do you know if the lidocaine contained Epinephrine (Adrenaline)?

Thank you so much. I am going to check with my dentist this week, I'll post what I find out.

For people w/a history of MCAS & POTS (like myself), I am supposed to use Mepivocaine without Epi (and without dyes) for dental work.

Right! I downloaded the ME Association Dental Care packet and it recommends just that:

"...avoid the use of anaesthetic solutions containing adrenaline if you suffer from ME."

It says try either Mepivacaine or Prilocaine (without adrenaline). I will ask for that next time.

Ugh, I'm sorry dental work has to be so scary and nerve-wracking for us.

 

[TinaYesen]

Just updating the chain, my dentist confirmed she used Lidocaine + Epinephrine. The Epi is likely what caused reaction. She added a note to my chart to not use Epi again.

 

[Strawberry]

Just updating the chain, my dentist confirmed she used Lidocaine + Epinephrine. The Epi is likely what caused reaction. She added a note to my chart to not use Epi again.

That is the most common mix……. Glad you have it on record.

 

[Pyrrhus]

David Systrom has an explanation for why some people with ME might have a bad reaction to the epinephrine in dental anesthetics. He explains that it might be due to a type of dysautonomia where there is inadequate stimulation of blood vessel constriction:

The chronic lack of activation of the sympathetic nerve cell would lead to up-regulation of the post-synaptic adrenergic receptors on the muscle cell controlling the blood vessel, leading to a more sensitive neuromuscular connection.

He backs up this idea with two experimental observations:

1. If you inject a POTS patient with norepinephrine, they exhibit excessive vasoconstriction, with profound circulatory effects. This is also seen in ME patients when they go to the dentist and are injected with a local anesthetic that contains epinephrine - the ME patients exhibit profound, scary circulatory symptoms. (which is why ME patients are advised to specifically ask for a non-epinephrine anesthetic when they visit the dentist)
2. If you stimulate the sympathetic nervous system in POTS patients, only a low level of norepinephrine is released, suggesting that the sympathetic nerve cells are not releasing their neurotransmitters appropriately.

From: Insights from Invasive Cardiopulmonary Exercise Testing of Patients with ME/CFS (Joseph et al., 2021)
https://forums.phoenixrising.me/thr...patients-with-me-cfs-joseph-et-al-2021.82907/

Immunohistochemical studies show that small fibers regulate microvascular tone, primarily by sympathetic and parasympathetic cholinergic synapses on perivascular myocytes. [...] Abnormal venous pooling in the legs on standing is demonstrated in POTS, and the excess peripheral venoconstriction to experimentally infused norepinephrine or phenylephrine documented is consistent with classic post-denervation adrenergic receptor upregulation. This is further supported by low norepinephrine release after sympathetic nervous system stimulation in POTS patients.

 

[Jjnz]

Acetylcholine based anesthetics use the BCHE gene for hydrolysis, I think its RS1799807
https://www.sciencedirect.com/topic...pharmaceutical-science/local-anesthetic-agent
In theory these take longer for the risk allel to hydrolyse

 

[ruben]

Wow, I have to remember this! I don't numb, and I have hypermobility/EDS...

My mom has made sure since I was a little kid that the anesthetist knew there was a family allergy, so I have always had "safe" anesthetics. But locals don't numb me!

I remember when I was about aged ten I was having an extraction after the injection. I hadn't gone numb and as the tooth was being pulled my mum heard me yell out while she was in the waiting room.!!!

 

[Strawberry]

@ruben thank you for reminding me of this thread! I need to update also, for my own memory.

This past summer, I had to have a skin cancer removed. When I first saw the dr, he numbed me to take a sample. It was so spur of the moment, I completely forgot about anesthesia reactions. So I was numbed by epinephrine and lidocaine. I reacted later that night with mild breathing difficulties, heart pounding, then a week later I developed a rash that looked like the injection diffusing down my face. From just a tiny drop.

So I told him about the allergy and how I reacted to the skin sample, and he made a special formula for just me. I had to be numbed 3 times to get all the cancer, but I had no reaction.

And yes, I’m healing well.

 

[Stretched]

For readers of this thread there’s an interesting discussion of the POSITIVE affects of Nitrous Oxide on MECFS when used with local anesthesia for dental work, and other application anomalies:
Dr. Jay Goldstein's Rapid Remission ME/CFS Treatments.

 

[L'engle]

I had a tooth extraction with IV sedation a couple of weeks ago. Worked fine, I remember nothing and felt nothing. I was worried the recovery would be long but it hasn't been. There wasn't much pain afterwards either. I just had to wait quite a long time for the appointment which was ok as the tooth was not painful.