Resistance to local anesthesia in people with the Ehlers-Danlos Syndromes presenting for dental surgery.
Dental Care
Ehlers-Danlos Syndrome
Local Anesthetics
Journal
Journal of dental anesthesia and pain medicine
ISSN: 2383-9309
Titre abrégé: J Dent Anesth Pain Med
Pays: Korea (South)
ID NLM: 101690691
Informations de publication
Date de publication:
Oct 2019
Oct 2019
Historique:
received:
21
08
2019
revised:
25
09
2019
accepted:
27
09
2019
entrez:
15
11
2019
pubmed:
15
11
2019
medline:
15
11
2019
Statut:
ppublish
Résumé
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. 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. 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%). 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.
Sections du résumé
BACKGROUND
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
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
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
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.
Identifiants
pubmed: 31723666
doi: 10.17245/jdapm.2019.19.5.261
pmc: PMC6834718
doi:
Types de publication
Journal Article
Langues
eng
Pagination
261-270Informations de copyright
Copyright © 2019 Journal of Dental Anesthesia and Pain Medicine.
Déclaration de conflit d'intérêts
DECLARATION OF INTEREST: The authors had no conflicts of interest to declare.
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