I have malignant hypothermia syndrome wich is triggered by any caine medications so what else can i use??

Question

malignant hypothermia is a genetic occurance wich will stiffin all muscles in body, raise body temps up to 105 degrees, and death can occur, this can happen very quickly. any anasthetics with "caine" in it is one of the triggers to this disease (novacaine, prolacaine,etc.) so please any info would be greatly appreciated. I need some dental work to be done and i have no idea what i can have. thank you

Answer 1

Lot's of patients have a problem with anesthesia for various medical reasons, we have a variety of suitable ones available to anesthetize you with. The Dentist will know which ones to use in your particular condition. Just be sure to note this on your health history information form and talk with the dentist before hand. Don't worry you won't have to bite a bullet to have work done.....because we need your mouth open! Couldn't resist, sorry. You'll be fine, we are well equipped to take care of your dental problems with any type of medical problem that you may have. Good luck, and don't let that keep you from going to the dentist.

Answer 2

Local anaesthetics were once thought to be a trigger associated with MH, but this is NO LONGER CORRECT. There has never been a situation where an MH episode occurred when LA was the only drug. In susceptible patients other factors may be precipitants: stress, excitement, infection - all of which can be found in dental offices. So, the NON-use of LA will lead to more pain and perhaps trigger an episode.
I suggest you see for yourself the latest guidelines from the MHAUS at:
http://www.mhaus.org/index.cfm/fuseaction/Content.Display/PagePK/AnestheticList.cfm

Answer 3

It's not so much the "caine" but the type of "caine" that seems to trigger episodes of malignant hypothermia. The more common "caines" used today are all amide-type solutions. The older ester-type solutions seem to be associated with less risk for you. I do not even know if these solutions are commercially available in dental-style cartridges. Procaine (the original and true "Novocaine") is an ester, but it has been abandoned due to its higher incidence of allergy and short duration of anesthesia.

I have used Benadryl injectable for a patient who was truly allergic to all "caine" anesthetics, but neither one of us thought it was very effective and she ended up just having her treatment without local anesthesia. She did occasionally use nitrous oxide, but she usually went "straight up."

You may have to investigate having dental treatment while under general anesthesia. This would be available in some private offices, although very few, or in a major teaching hospital. Personally, I would choose the teaching hospital. If you are near a city, start calling the hospitals to see if they have a dental residency program and then schedule an appointment for an examination.

You are lucky to be aware of your condition. I am aware of one patient who was killed in a local dentist's office (not mine!) who did not know that they had this condition. The dentist did not recognize the very rapidly progressing symptoms and resuscitative measures were not successful.

Personally, I'd go to the hospital for care if I were you.