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Anesthesia

True Local Anesthesia Intolerance

09/24/2009

Question:

I have a condition where my body absorbs any kind of local anasthetic too fast, even in small amounts. This causes multiple problems, not only can they not numb me as a result, I have severe cardiovascular and neurological effects. I have had to leave the dentist office twice now in an ambulance. The first time they thought it was a vein injection, but it has happened 5 times in a row. I have a molar that needs to be pulled. What are my options? I just had a root canal, crown done with no anasthetic and I never want to do that again. The wedges caused the worse pain I ever felt! There is no way I can tolerate a tooth being pulled withough being numb. The tooth is unsaveable and is now affecting the bone. I have been to an allergist, not a true allergy, but a metobolic problem, probably due to the fact I have a few autoimmune diseases. Any advice I will take. I am desperate.

Answer:

What you are describing is definitely unusual.

I cannot say what the problem is in terms of your reactions to any kind of local anesthetic. That would require a proper evaluation by your dentists and/or doctors with access to your medical records, including the autoimmune diseases that you mention. Based solely on the questions I've received in this forum there certainly are individuals who seem to be "resistant" to local anesthetics, requiring many times the normal dose, or much longer for the local anesthetic to act. This does not however seem to be a phenomenon that is clear cut or well studied. It may be related to genetically based differences in cell receptors.

There are also some common reactions to local anesthetics, related either to absorption of the anesthetic or the adrenaline (epinephrine) that is added to it. Such patients may experience palpitations, dizziness or anxiety, for example.

The obvious solution to your current problem is to have the dental procedure that you need with general anesthesia rather than local. There will be added costs but this is safe and reliable. Such procedures can be done in suitably equipped outpatient surgery centers, or in hospital.

For more information:

Go to the Anesthesia health topic, where you can:

Response by:

Gareth S Kantor, MD Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University