Trouble with adrenaline-containing anaesthetics

[wwinter]

Hi,

I used to have no issue going to the dentist at all until one time when I had to get a wisdom tooth removed. The dentist injected me with local anaesthetic and my heart rate spiked to over 170 BPM almost instantly.

I felt like I was going to die for about half an hour. They just put me in the recovery room and nobody seemed to be trying to help me. They basically kept me in there alone until my heart rate eventually calmed down and then I left without having the procedure done.

The dentist explained what happened - that it was something to do with the adrenaline getting into a blood vessel rather than into the tissue to numb it. That it's a common reaction and that I should ask for anaesthetics containing no adrenaline going forward if I'm concerned about it happening again.

I did exactly that, but the adrenaline free stuff just barely works for me. Hardly gets me numb at all and only lasts for like 30 minutes.

I had to have an onlay done for a cracked tooth a while back, and during the etching process I literally felt like someone was ramming an ice pick into my tooth. I've had pain ever since (in agony as I write this), and I'm terrified of going back to the dentist because I might need a root canal. I've had one before when I had the normal anaesthetic without issue several years ago, but based on how sore just having an onlay bonded, I'm terrified that I'll have to go through even more pain with this. Like when I got the onlay, I just may as well have not had any numbing - it barely worked.

Can anyone give me any advice? I'm in misery here.

Thanks so much.

 

[Gordon]

There are loads of non-Adrenaline locals, without knowing which you got it's kind of hard to suggest anything, some are very short acting, others last as long as regular LA with adrenaline or even longer.

Inadvertent IV injection usually only happens during inferior dental blocks, even then it's pretty rare, so you could just have regular LA with adrenaline for non-IDBs and then discuss options for non-Adrenaline locals for IDBs?

 

[wwinter]

That's exactly what happened - from googling it, that's what I had when this happened: an IDB. I'm guessing it went straight into the artery located there behind the nerve.

I guess if I had a serious issue with adrenaline-containing LA, I'd have had problems during the years that I had been going to the dentist before this happening.

Maybe I'll give this a go. The non-adrenaline LA just doesn't seem to work for me.

Is this type of reaction relatively rare for non-IDBs? As in, have you ever seen it before?

Thank you!

 

[Monica82]

I don't mean to hijack this thread but this reaction to local anesthetic is probably my biggest fear of getting dental treatment, due to one time having a panic attack that a dentist attributed to it (although I was already anxious and I can't be completely sure this was the cause). I always have elevated blood pressure at the dentist - no where else - and have read it can cause heart rate and blood pressure to increase even more. I've read on here that this is not harmful and have mostly read the same thing Googling (I know, I know - Google is not a good place to be looking at health info for the anxious). I try to tell myself too dentists see patients in much more fragile health than me and they are probably mostly receiving the same type of anesthetic. Like the original poster, my one time bad reaction could have been injection into a blood vessel, since I'd not had issues before and I believe the injection may have been this type of nerve block. I talked to my current dentist about it when I first saw her (even though I haven't needed LA then or since) and she advised against the non-adrenaline LA since she said it can be shorter lasting and the adrenaline rush my body would make from a sudden sensation of pain would be more than the shot. I trust her judgement that it's safe for me yet I still worry about whenever I might need it in the future.

Can anyone please confirm that even if we have this reaction it does not mean we're going to die? That there's only so much it can raise your blood pressure and heart beat? I think I could deal with the sensation again, if I knew it was truly not harmful, because I'd prefer something long lasting to keep the procedure pain free. I realize, realistically, that if it were really a problem you'd be hearing about people dying from it, yet I can't get over the fear that the next injection I have is going to be "the one" for me. I guess I just don't understand how something that can raise your blood pressure and heart rate couldn't potentially cause a heart attack or stroke?

 

[Gordon]

Can anyone please confirm that even if we have this reaction it does not mean we're going to die?

Sure. You're not going to die from it. Your body is perfectly capable of handling a short term increase in pulse or BP.

 

[Gordon]

I'm guessing it went straight into the artery located there behind the nerve.

Pedantic hat on... into the vein, injecting into an artery is very difficult.

Is this type of reaction relatively rare for non-IDBs? As in, have you ever seen it before?

Very very rare, you're not injecting anywhere near a large(ish) vein.

The non-adrenaline LA just doesn't seem to work for me.

We don't know which one, so you can't really make that blanket statement, there are many different types.

 

[wwinter]

Thanks @Gordon I really appreciate you taking the time to reply to me here. I'm going to book an emergency appointment for my dentist tomorrow and I'll ask them to try the standard LA so I don't have to suffer so much.

For today, I'll just have to live with swishing whiskey around my tooth to get by. Could be worse!