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Hötschl F, Lirk P, Marti F. Failure of local anesthesia : Technical shortcoming or true resistance? DIE ANAESTHESIOLOGIE 2023; 72:723-725. [PMID: 37280377 DOI: 10.1007/s00101-023-01295-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/27/2023] [Indexed: 06/08/2023]
Affiliation(s)
- Franz Hötschl
- Abteilung für Anästhesie, Intensivmedizin, Rettungsdienst und Schmerzmedizin, Bürgerspital Solothurn, Schöngruenstr. 42, 4500, Solothurn, Switzerland.
| | - Philipp Lirk
- Department of Anaesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Florian Marti
- Abteilung für Anästhesie, Intensivmedizin, Rettungsdienst und Schmerzmedizin, Bürgerspital Solothurn, Schöngruenstr. 42, 4500, Solothurn, Switzerland
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Hötschl F, Lirk P, Marti F. [Failure of local anesthesia : Technical inadequacy or true resistance?]. DIE ANAESTHESIOLOGIE 2023; 72:106-108. [PMID: 36474080 DOI: 10.1007/s00101-022-01231-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 10/30/2022] [Accepted: 11/02/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Franz Hötschl
- Abteilung für Anästhesie, Intensivmedizin, Rettungsdienst und Schmerzmedizin, Bürgerspital Solothurn, Schöngruenstr. 42, 4500, Solothurn, Schweiz.
| | - Philipp Lirk
- Department of Anaesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Florian Marti
- Abteilung für Anästhesie, Intensivmedizin, Rettungsdienst und Schmerzmedizin, Bürgerspital Solothurn, Schöngruenstr. 42, 4500, Solothurn, Schweiz
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Marti F, Lindner G, Ravioli S. Resistance to local anaesthetics: a literature review. Br J Anaesth 2022; 129:e43-e45. [PMID: 35718562 DOI: 10.1016/j.bja.2022.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 04/22/2022] [Accepted: 05/13/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Florian Marti
- Department of Anaesthesiology and Intensive Care Medicine, Buergerspital Solothurn, Solothurn, Switzerland.
| | - Gregor Lindner
- Department of Internal and Emergency Medicine, Buergerspital Solothurn, Solothurn, Switzerland; Department of Emergency Medicine, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Svenja Ravioli
- Department of Internal and Emergency Medicine, Buergerspital Solothurn, Solothurn, Switzerland
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Schubart JR, Schaefer E, Janicki P, Adhikary SD, Schilling A, Hakim AJ, Bascom R, Francomano CA, Raj SR. Resistance to local anesthesia in people with the Ehlers-Danlos Syndromes presenting for dental surgery. J Dent Anesth Pain Med 2019; 19:261-270. [PMID: 31723666 PMCID: PMC6834718 DOI: 10.17245/jdapm.2019.19.5.261] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 09/25/2019] [Accepted: 09/27/2019] [Indexed: 12/28/2022] Open
Abstract
Background People with the Ehlers-Danlos Syndromes (EDS), a group of heritable disorders of connective tissue, often report experiencing dental procedure pain despite local anesthetic (LA) use. Clinicians have been uncertain how to interpret this apparent LA resistance, as comparison of EDS and non-EDS patient experience is limited to anecdotal evidence and small case series. The primary goal of this hypothesis-generating study was to investigate the recalled adequacy of pain prevention with LA administered during dental procedures in a large cohort of people with and without EDS. A secondary exploratory aim asked people with EDS to recall comparative LA experiences. Methods We administered an online survey through various social media platforms to people with EDS and their friends without EDS, asking about past dental procedures, LA exposures, and the adequacy of procedure pain prevention. Among EDS respondents who both received LA and recalled the specific LA used, we compared agent-specific pain prevention for lidocaine, procaine, bupivacaine, mepivacaine, and articaine. Results Among the 980 EDS respondents who had undergone a dental procedure LA, 88% (n = 860) recalled inadequate pain prevention. Among 249 non EDS respondents only 33% (n = 83) recalled inadequate pain prevention (P < 0.001 compared to EDS respondents). The agent with the highest EDS-respondent reported success rate was articaine (30%), followed by bupivacaine (25%), and mepivacaine (22%). Conclusions EDS survey respondents reported nearly three times the rate of LA non-response compared to non-EDS respondents, suggesting that LAs were less effective in preventing their pain associated with routine office dental procedures.
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Affiliation(s)
- Jane R Schubart
- Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.,Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.,Department of Medicine, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Eric Schaefer
- Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Piotr Janicki
- Department of Anesthesiology and Perioperative Medicine, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Sanjib D Adhikary
- Department of Anesthesiology and Perioperative Medicine, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Amber Schilling
- Department of Surgery, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Alan J Hakim
- The Wellington Hospital, Platinum Medical Centre, London, UK
| | - Rebecca Bascom
- Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, USA.,Department of Medicine, The Pennsylvania State University, College of Medicine, Hershey, PA, USA
| | - Clair A Francomano
- Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Satish R Raj
- Vanderbilt University Medical Center, Nashville, TN, USA.,Department of Cardiovascular Science, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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Bouhassira J, Lange F, Hersant B, Bosc R, Meningaud JP. Body contouring surgery in a patient with Ehlers–Danlos syndrome. EUROPEAN JOURNAL OF PLASTIC SURGERY 2014. [DOI: 10.1007/s00238-014-0999-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Whitaker IS, Rozen WM, Cairns SA, Howes J, Pope FM, Hamish Laing J. Molecular genetic and clinical review of Ehlers–Danlos Type VIIA: implications for management by the plastic surgeon in a multidisciplinary setting. J Plast Reconstr Aesthet Surg 2009; 62:589-94. [DOI: 10.1016/j.bjps.2008.11.119] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2008] [Revised: 11/13/2008] [Accepted: 11/15/2008] [Indexed: 11/26/2022]
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