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Posted: Sat Oct 29th, 2005 22:13 |
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Why do I need to ask for a local anesthetic without epinephrine?
Epinephrine, norepinephrine or one of its analogs called levonordefrine, is commonly added to local anesthetics given for dental procedures and other minor surgical procedures requiring a local anesthestic. The exact biochemical reaction is unknown but some people with Th1 inflammatory diseases react abnormally to epinephrine in a local anesthetic. There are many anecdotal accounts of patients with Th1 inflammatory diseases experiencing increased local inflammation (redness), local tissue damage, decreased anesthetic effect (numbness) and systemic reactions such as palpitations, rapid heart rate, anxiety, tremor and headache following injection with a local anesthetic containing epinephrine.
Adverse reactions associated with norepinephrine in dental local anesthesia.
Epinephrine (also known as adrenaline), is produced by the adrenal glands in response to stress and is sometimes called the “fight or flight” hormone. Th1 inflammatory diseases can cause patients to have abnormal reactions to stress. In addition to causing a constriction of blood supply, if epinephrine enters the general circulation it can cause an increased heart rate and stronger heart beat, along with a feeling of nervousness. These side effects account for the "rush" that some people feel after receiving an anesthetic shot. Epinephrine in a local anesthetic is also contraindicated in hyperthyroid patients and those taking tricyclic antidepressants.
Epinephrine is not an essential component of a local anesthetic. Its only function is to reduce the reabsorption of the anesthetic by constricting blood vessels to prolong the numbing action of the anesthetic.
Lidocaine, xylocaine, prilocaine and mepivicaine (Isocaine) are common local anesthetics that are available without epinephrine. Although these ‘locals’ are short acting without the vasoconstrictor added, they still produce adequate anesthesia for short procedures and can be readministered as needed.
You can avoid potential uncomfortable reactions by insisting that your dentist or doctor “hold the epinephrine” when using a local anesthetic.
"Why does everybody always assume that there is a complex answer to the adrenaline (nor/epinephrine) sensitivity? The solution is simple. Some species, particularly Mycobacterium leprae, are known to feed directly off nor/epinephrine in the nerve endings. This has been documented for many years. http://tinyurl.com/27n2qg
Remember the pea soup..."
..Trevor..
See also DENTAL PROBLEMS and Th1 inflammation
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Epinephrine use (Epi-pen) for allergic reaction
The decision to use an epi-pen after exposure to a known allergen and in the presence of worrisome systemic symptoms should be an individual one.
One MP member decided to wait and watch after a bee sting with the epi-pen and supportive help at hand. He had experience with allergic reactions and was prepared to act if necessary. To his surprise, the symptoms subsided without the need to use epinephrine.
Another option would be to head to the ER with your epi-pen in hand and someone else driving. Use a topical OTC cortisone preparation at the site of the bee sting but use the epi-pen if symptoms become alarming. Or call 911 if you want to try to avoid using your epi-pen but want emergency personnel on hand.
We are not suggesting that you should not use a medication prescribed by your doctor for an emergency situation. Rather you should use your good judgement, don't panic and take epinephrine only if you feel it is necessary.
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Dr. Marshall wrote: "The epi pen is OK if Doc tells you to use it, and if you have not reacted badly to it in the past. Some Th1 patients find that epinephrine does not work properly for them. Rather than constricting the flow of peripheral blood, it causes vasodilation, and increases perfusion in the periphery, tather than decreasing it.
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Epinephrine in an emergency situation
In an urgent or emergency situation the risk/benefit weighs heavily in favor of the use of epinephrine.
The use of epinephrine is primarily a problem when dealing with surgery, including dental surgery.
..Trevor..
The guide for ER staff is at
http://AutoimmunityResearch.org/ER.pdf
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Aussie Barb
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Posted: Sun Oct 30th, 2005 00:33 |
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Shamutooth wrote: Personal Experience.
I forgot to make sure my dentist didn't use epinephrine during some dental work I had done a couple weeks ago. I had a pretty bad reaction to it. Heart herx was tremendous and lasted several hours. I think I scared the heck out of my dentist Everyone on MP should be very careful. Sam
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Barb: Dx Inflammatory Disease Endocrine Imbalance 2003| Depression| 24+ years not Dx| MP Aug04| ABC of MP| MP Search|
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Posted: Thu Jan 26th, 2006 04:47 |
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Rosie wrote: noepitakestimelink
I always request dental anesthesia without epinephrine. The usual scenario is:
1. after the first injection the dentist leaves the room and returns every several minutes to check to see if it is numb yet - usually it is not
2. he then adds a little more and goes through the same waiting process; sometimes he needs to add a little more until it is finally numb.
3. the procedure is painless
4. the major numbing effect of the numerous injections kicks in long after the procedure is over, a little annoying but worth the painless procedure.
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