The epinephrine in local anesthesia sometimes makes my heart beat faster. Soon after receiving five injections for a root canal three weeks ago, my legs started shaking and I couldn’t get them to stop. After at least three procedures involving injections (two root canals, one crown), I felt like crying when I got home.
I freely admit to being an anxious and emotional person. I mean, my dog died a month ago and I miss my daughters (still)! But I’m curious whether other people ever have these or other effects of local anesthetics.
Some people notice the effect of the epinephrine more than others do. I have a coworker who finds it very uncomfortable.
There is a local anesthetic available without the epinephrine. I remember the dentist using it when I needed a crown during the period when I was breastfeeding a baby (the epinephrine is apparently contraindicated during breastfeeding). But this alternate anesthetic doesn’t work as well. It may take longer to take effect, and you may need a larger number of shots.
I mentioned the heartbeat and shaking issues today. They seem to fall within the realm of normal, but, as the dentist told me afterward, I shouldn’t “practice for a marathon today.”
I have a dental phobia and the meds I need to take for that counteract the epinephrine so my PVCs aren’t too bad. Normally I can’t do epinephrine or any antihistamine without getting the jitters.
My bigger problem is that I don’t metabolize the anesthesia well. I get an injection and have to sit for up to an hour before it takes effect.
I’d notice it when I was drinking caffeine and needed crowns. I could contrast that to times when I wasn’t drinking caffeine and needed crowns. My heart wouldn’t race when I was off caffeine.
:)) I had 4 baby teeth that needed to be replaced eventually so I had years of dental work.
Epinephrine can definitely cause rapid heart beat, etc. I once had recurring serious, major episodes of hives, and the only way to get them to resolve was to give me several shots of epinephrine. Made my heart race like crazy, but at least the hives went away.
I cannot take epinephrine or any sulfites/sulphites so after much discussion between my dentist and my Mayo allergist, we went with Carbocaine (I think it was called Carbocaine 3% - but verify). This past year I had to have 2 dental implants and 1 root canal. I did just great…jitter free and my heart rate was just just fine. It does not last as long, so during one of the procedures I needed a 2nd dose.
I am thankful everyday that they figured out a way to medicate me.
Interesting. I’ve always been jittery after dental procedures, but I thought it was due to my anxiety regarding the dental procedures.
Many years ago when I had to have a filling, the dentist refused to believe me when I told him I wasn’t numb and started drilling. After that I’ve actually broken down and cried when told I need a filling. The dentist took note and usually gives me two injections of novacaine for a simple filling, which is probably the reason for being jittery. I’ve had to switch dentists this year due to insurance and I will definitely have to talk about this with the new dentist.
DH is a retired dentist, and says there is definitely anesthesia without epinephrine (e.g., Carbocaine 3% w/o epinephrine). He also said diabetics should definitely not have epinephrine because it tends to lead to hypoglycemia.
I have a heart valve condition and, as I’ve gotten older, stimulants have caused me to have tachycardia - sometimes fairly serious - once I took a “Sudafed” and my heart raced at 160 for over 9 hours and I had to go to the ER. So my doctor has advised me to avoid all stimulants including caffeine, pseudophedrine, albuterol, and dental anesthesia with epinephrine.
When I go to the dentist, I just ask for the non-epinephrine anesthetic and have always been accommodated. Dentists want patients to be comfortable and definitely don’t want to induce any cardiac side effects on them. I don’t know why your dentist didn’t offer to switch anesthetics - I’d definitely make that request for your future procedures.
I think some dentist also need to revisit their pain minimization lessons.
Long ago, I had a dentist who was very particular about where he placed the injections. He was the best! The injections hurt less and were more effective for me than any other dentist I had previously or since. I usually need multiple injections to get numb and with my high blood pressure, my current dentist doesn’t give me jitters. Bless her for being smart!
My doc does conscious sedation, and it’s awesome. You sort of fall asleep, but are awake enough to be roused if necessary and when he is done. You take a little nap and it’s all over. This is what we do for any significant work, but I could barely walk afterward, needed help to get home, and immediately went to sleep for hours. I’m a lightweight when it comes to drugs and don’t need much. It barely affected one of my kids though, who was tired, but could walk just fine and stayed up awhile after. Everyone is different.
Sounds like you reacted to all of the injections and that is not the way it should be. I’m sorry.
Thanks for all the posts. I’ve decided, based on them, that even though my response to the anesthetic does not seem unique, I will ask my primary care physician about the issue.
@rosered55 After you discuss it with your PCP, bring it up with your dentist. S/he likely knows more about the dental anesthetics and the reactions than your doctor. There are options available without epi.
Yes, I will talk to both. I want to talk to my primary care doctor because I’ve had bothersome heart symptoms in the past in other contexts, and I’d like to get my doc’s opinion about whether the anesthetic-related symptoms suggest an underlying problem that I should be generally concerned about.
Physician here (long retired anesthesiologist). The absorption of too much epinephrine can be a serious problem. Too many injections at one sitting or a patient’s medical condition can affect a person adversely. Definitely tell the dentist. A good dentist will deal with the issues and tailor the local anesthetic (with/without epinephrine) to the patient’s needs. “One size fits all” dental anesthesia is not the mark of a good dentist.