Local anaesthetic with POTS please help!

[bombsh3ll]

Does anyone have any experience or advice regarding local anaesthetic injections with POTS?

I am having a lip biopsy on Tuesday to test for Sjogren's as a cause for my POTS, which will be done with local anaesthetic. 

Obviously I do not want anything with adrenaline or that is adrenergically acting. I have seen a fellow EDS patient in a really bad way, whole body shaking etc for many hours after a dental local anaesthetic, and she doesn't even have POTS. 

I do not trust the medical team to know anything about POTS or even be bothered to look it up, so I would like to know for myself what is safe/what to avoid in terms of local anaesthesia. 

I would rather have it done with no anaesthetic than receive anything adrenergic. I am travelling to and from the hospital alone on the bus in my wheelchair, so cannot afford to be a mess afterwards. 

Any experiences much appreciated.

B x

[Pistol]

I have hyperadrenergic POTS and have had problems with anesthesia but have had local anesthesia at my dentist without problems. However - he used what he called " the old " anesthetic which apparently has less adrenalin. Not sure what that is, sorry. But to be on the safe side - PLEASE arrange for someone to go with you and can bring you home in case there are problems. 

[Clb75]

I usually get dental anesthetic without the epi in it. It works but it wears off faster so they have to give me a couple of injections to make it through the procedure. I know you’re a physician yourself, so it wouldn’t hurt to touch base with your team beforehand and give them a heads up about your concerns. Even if they don’t know about POTS, they would probably take it more seriously since you are a physician. A lot of people are allergic to the epi in anesthesia so I’m sure they have an alternative. Hope everything works out ok. 

[GardenGal]

Agreed on avoidance of the Epinepherine, but have also had trouble with prilocaine (other name citanest) even though it doesn't have Epi. See side effects.

However, I now request Carbocaine (other names: polocaine, mepivacaine) and have done just fine with it. None of the awful winded cardiac dizzy thing I've experienced in the past. It is shorter acting, and I request it special ordered before appointments. So while I don't know if it would work for you, for me it's been such a relief to know I'll do just fine with it. Hope your biopsy goes OK. That can be nerve wracking. 

[Pistol]

@bombsh3ll - how did it go? U OK? Did you tolerate the procedure? What did they end up giving you? I hope U R well …. ?

[bombsh3ll]

Thanks for all of your replies. I explained that I had POTS and SHOULD NOT be given anything with adrenaline in it. They had no clue what POTS was but made sure I got an adrenaline free LA, lidocaine. I was fine with this and had no side effects & I would recommend it for anyone with POTS or hyperadrenergic issues needing a local.

[Pistol]

Thank you for the update - I am so happy you did well. I know how scary any procedures are for us! This will surely answer some questions for others. I hope your biopsy comes back negative. My M-I-L has Sjorgens syndrome, so I am quite familiar with it 

[bombsh3ll]

Thanks, I am not sure what to hope for - in a way Sjogren's would give me some treatment options,  best case I might even be able to get IVIG but I don't think the NHS would fund that. 

B x