Sedative Local Anesthetic?

[Ameloblast91]

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Which local anesthetic causes sedation in a patient?
That is, without sedation being as a result of overdose toxicity.



Happy Holidays ! 🙂

 

[Decan]

I may be mistaken, but I thought all local anesthetics (with the exception of cocaine) cause sedation...

 

[Ameloblast91]

Actually, local anesthetics have no CNS manifestation at normal doses. It's the increase in the local anesthetic blood level (toxicity) that triggers the sedative effect.
However, there is a local anesthetic that could cause sedation in a patient without the high dose,,

 

[caffeinehigh]

Which local anesthetic causes sedation in a patient?
That is, without sedation being as a result of overdose toxicity.



Happy Holidays ! 🙂

Diphenhydramine does block sodium channel when injected locally, and as a first generation histamine blocker crosses the BBB and causes sedation.

 

[preOMFS]

Lidocaine is metabolized by hepatic carboxylesterase into monoethylglycinexylidide which can be sleep inducing.. .

 

[caffeinehigh]

Lidocaine is metabolized by hepatic carboxylesterase into monoethylglycinexylidide which can be sleep inducing.. .

Can you cite a source that MEGX is sedative at normal dental doses of lidocaine? 😕

 

[Ameloblast91]

Diphenhydramine does block sodium channel when injected locally, and as a first generation histamine blocker crosses the BBB and causes sedation.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2516640/

Yes! Thank you so much!

 

[DrJeff]

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2516640/

Yes! Thank you so much!

Okay, but can Diphenhydramine provide PROFOUND pulpal anesthesia for enough working time to accomplish say endodontic therapy on #3 or say the surgical extraction of a full bony impacted #17 in actual clinical situations?? (Even Stan Malamed, the "anesthesia guru" himself, said that this wasn't the case in that article)

While I don't have any data to prove this, my strong hunch is that you could count the number of dentists in the US who use Benadryl as their primary local anesthetic for performing dental work on 1 hand and still have a few fingers left over 😉

 

[armorshell]

Of course no one uses it, but this sounds like a dental school test question.

Technically it's a local anesthetic and technically its sedating, and its extremely obscure, so therefore its a PERFECT test question.

 

[DrJeff]

Of course no one uses it, but this sounds like a dental school test question.

Technically it's a local anesthetic and technically its sedating, and its extremely obscure, so therefore its a PERFECT test question.

I can guarentee that the vast majority of parents of younger kids can attest to the WONDERFUL sedating properties of Bendryl for a cranky kid 😉😀

Diphenhydramine, it's NOT just for the emergency kit at your office, its also an essential item in the ever important home "cranky kid kit" 😀

 

[Ameloblast91]

Of course no one uses it, but this sounds like a dental school test question.

Technically it's a local anesthetic and technically its sedating, and its extremely obscure, so therefore its a PERFECT test question.

Yes, it was =)

 

[caffeinehigh]

Of course no one uses it, but this sounds like a dental school test question.

Technically it's a local anesthetic and technically its sedating, and its extremely obscure, so therefore its a PERFECT test question.

I actually think I saw this questions on NDBE 2 recently?