The dentist gave me a shot to numb me up and after a few minutes went by, he came back and asked me if I was ready for one more shot, I said, “sure, go for it, I am pretty numb by now”.
So, in it goes and about three seconds of him pressing the plunger, my heart started to beat extremely fast, I started getting PVCs, my face felt like it was on fire and my ears started ringing loudly. I was really scared and uncomfortable and it came over me really fast. Uncontrollable fear.
I literally popped up from a fully reclined position in the chair and said “what was that, Doc?” and he said, “epinephrine, are you alright?” and I told him all my symptoms and he said to just sit there and he’ll get me some water and in a few minutes I won’t have any more symptoms.
He was right, so they took my vitals and in about ten minutes I was getting my tooth pulled, the one right behind my canine on the bottom left. No more problems after my little episode. I paid them, thanked them and left.
Any ideas why I as given this adrenaline shot? I never did ask the doc, I was too worried at the time.
What you describe is exactly the reaction I have when receiving epinedrine as part of a Novocane shot (on more than one occasion). In one case I past out briefly then awoke standing and clutching the edge of the dentist’s chair while a worried dental hygenist asked if anything was the matter; it was, to say the least, an unnerving experience.
The dentist told me epinedrine is added to make the anesthetic numb more effectively/spread out further, and it seems to be a standard procedure. I now have NO EPINEDRINE written in large letters on my dental chart. I have not noticed any problems with dental anesthesia without epinedrine, but it’s not like I get numbed up at the dentist that often.
The epi is supposed to be infused into the tissue, NOT into a blood vessel. The idea is that the epi causes constriction of the local blood vessels, which has two benefits in this situation: the decrease in local blood flow means that the local anesthetic will get ‘washed out’ more slowly, and there will be less bleeding with the vessels all clamped down. There are premixed lidocaine/epi solutions to achieve this effect. The blood vessel constriction can be so significant that epi is contraindicated in some situations (fingers come to mind) - although this is more of a guideline than a cast-in-stone rule. However, if the epi is injected directly into (or gets into) a vein, it can travel throughout the body and trigger all the effects you mentioned. Ideally one will draw back slightly on the syringe to make sure that one is not in a vessel before injecting the epi, but it is possible to go through a small vessel without noticing and end up with an intravascular injection.
I get a reaction similar to the OP, but more extreme, with epinephrine. I also get hallucinations and the ‘feeling of imminent death’ which is a very bad cardiovascular sign.
I used to occasionally get the shots when I was a kid and my asthma was really bad. They would give me the shot, tell me it would ‘feel weird’ and leave me alone in a room. When they came back and asked me how I felt, I said I felt ‘weird’.
Not surprisingly, I’ve never been interested in trying hallucinogens for fun. I think they’re ‘weird’.
Doctor Spiller’s excellent dentistry web site has a detailed article about local anesthetics and how they work; page 2 explains the purpose of vasoconstrictors like epinephrine.
It looks like the reason for epinephrine has already been explained, but it’s always worth visiting Dr. Spiller’s site.