The Science Behind It
Anesthesia is processed in the liver by enzymes, but genetic mutations common in EDS can alter how these enzymes function, slowing down the breakdown of anesthetic drugs. This phenomenon, known as altered pharmacokinetics, can cause anesthesia to remain in the body longer than expected, leading to prolonged sedation, delayed wake-up times, and respiratory depression. Additionally, individuals with EDS may have variable responses to anesthesia. Some requiring higher doses to achieve sedation, while others experience heightened sensitivity to even small amounts. This unpredictable reaction makes personalized anesthetic planning essential for ensuring patient safety and effective pain management.
Other Medications Matter Too
Other drugs given before or during surgery, like opioids or benzodiazepines, can further complicate anesthesia recovery. These drugs can stack up and make it harder to wake up or breathe normally.
Dental Anesthesia & eds
Ehlers-Danlos Syndrome (EDS), dysautonomia, and Mast Cell Activation Syndrome (MCAS). Local anesthetics often contain epinephrine, which prolongs numbness but can also trigger rapid heart rate, dizziness, or anxiety due to nervous system sensitivity.
Beyond epinephrine, other commonly used medications like norepinephrine, nitrous oxide, sedatives, and antihistamines, can impact blood pressure, autonomic function, and overall comfort. Understanding these interactions is key to safer, more tailored dental care. If you have EDS, communicating with your dentist about medication sensitivities can make all the difference.
In dental procedures, epinephrine is added to local anesthetics like lidocaine for two main reasons: it makes the numbness last longer and it helps reduce bleeding.
Epinephrine constricts blood vessels, which slows the absorption of the anesthetic into the bloodstream, so it stays active at the injection site for longer. This effect also reduces blood flow to the area, which helps with bleeding.
Why This Matters for EDS, Dysautonomia, and MCAS
For people with EDS, dysautonomia, or MCAS, though, epinephrine can cause some uncomfortable side effects. These conditions often come with nervous system sensitivity, so when epinephrine raises heart rate and blood pressure, it can feel way more intense causing symptoms like dizziness, rapid heartbeat, or even anxiety.
Other Medications Used in Dental Work
Epinephrine isn’t the only medication to watch out for. Here are a few others commonly used during dental procedures that might trigger similar reactions.
Norepinephrine and Levonordefrin: These are sometimes added to anesthetics for similar reasons as epinephrine. But for people with dysautonomia or EDS, they can also increase heart rate and blood pressure.
Nitrous Oxide (Laughing Gas): Laughing gas is generally safe, but it can make people with autonomic issues feel dizzy or overstimulated. Some people with dysautonomia find it uncomfortable.
For individuals who are sensitive to epinephrine, alternative anesthetics like carbocaine (mepivacaine), which do not contain vasoconstrictors, may be a better option. Discussing these alternatives with your dentist can help prevent unnecessary side effects while still ensuring effective pain management.
Sedatives and Antihistamines
Sedatives and Antihistamines: Sedatives like benzodiazepines help patients relax but can drop blood pressure, which may increase dizziness in people with autonomic issues. Antihistamines are often used to prevent reactions in MCAS, but high doses can lead to drowsiness or low blood pressure.