Is there a general rule concerning anaesthetic containing Adrenalin for dental work, for people taking a NOAC?

[Mickey16]

Hi, I wondered whether any one knows whether there is a general rule concerning anaesthetic containing Adrenalin for dental work, for people taking a NOAC?

Many thanks.

[Finvola]

Hi Mickey. I don’t think there is a rule as such, as many people with AF are unaffected by adrenaline in anaesthetic.

I have had adrenaline free injections administered by three dentists and in each case it was at my request. None of the three seemed surprised by the request and were happy to comply.

[Hidden]

Hi Mickey. I have been on both NOAC's and then switched to Coumadin. Before any dental work I have always checked with my EP for his input. Some years ago while on the NOAC's he told me no probs/ nochanges necessary. Then 2 years ago I had to have 2 back crowns pulled. I had already switched to Coumadin and was doing my own INR's at home My EP said stop the Coumadin 2 days prior; and checkmy INR daily for several days to be sure it was going down. The EP wanted the INR ar 2.0 We achieved this goal, the dental procedure went fine with no excess blood loss. I would say depending on what the dentist plans to do , tell your EP/cardiologist and ask him to speak directly to the dentist if he feels things should be done a certain way. Every case is different so I don't want to generalize. Hope this helps. Take care. irina1975

[Mickey16 in reply to Hidden]

Thank you for your reply irina1975. I am going to have a crown too. Unfortunately my EP has moved on so currently don't have anyone assigned? or in place. I think as Finvola has suggested I will err on the side of caution.

[Hidden in reply to Mickey16]

Good idea. I've seen reactions to adrenaline in the O.R. Not sure all the staff in various medical and dental offices are well-trained in "crash cart etiquette". I will think about the adrenaline next time dental work comes my way. I trust my dentist but I don't know how some of his staff would react to an emergency. Not very trusting, am I?

[CDreamer]

It’s nothing to do with the AC’s - it is the effect of adrenaline on AF - I passed out within seconds of having a local containing adrenaline - thankfully my dentist of the time was very quick to notice I was reacting - it was also to do with tilted position as well. I have avoided adrenaline since!

[Mickey16 in reply to CDreamer]

You can do without that happening CDreamer! Glad you had a good dentist! Thank you for your reply.

I think I will err on the side of caution.

[Mejulie69]

I had a non adrenaline anaesthetic at my own request a couple of months ago, and it was not effective at all. I screamed on a couple of occasions. I won’t be asking for one again!

[Mickey16 in reply to Mejulie69]

Oh dear - that does not sound good. I have sensitive teeth at the moment.... ((:

[Finvola in reply to Mickey16]

My dentist explained that adrenaline helps to hold the anaesthetic in the tissues and this makes it more effective. He also said that if I needed he could give an extra shot of the adrenaline free stuff - I was having a large tooth taken out. I was nervous but felt nothing at all.

Mejulie’s experience sounds awful and I would have shouted for another shot.

[Gilldy in reply to Mickey16]

I've got very sensitive teeth and I've had adrenaline free anaesthetic for the last 10 years with no problems. It takes a little longer to work but that's good as my dentist checks I'm numb before starting.

[Susan728 in reply to Mejulie69]

I’m assuming that’s what my dentist gave me as well. My body processed it quickly so he would have to give me more shots throughout. If I felt anything, I told him and he would give me another shot. Never suffer in pain! Tell your dentist and ask for more!!

[opal11uk]

Yes, I was told years ago to ask for adrenalin free anaesthetics at the dentist so I do.

[Bagrat]

Dentists have a series of protocols for adrenaline free injections. AF is not on this list. I've had both, both equally effective though I was less relaxed with adrenaline free in case it wasn't as effective. Adrenaline is produced in the body anyway if you are apprehensive about treatment.

[Mrspat]

Not sure if there is a hard and fast rule but I always ask for local anaesthetic without Adrenalin. It won’t affect your anticoagulation but it might react with your heart rate. I recently had a general anaesthetic for non dental purposes. The anaesthetist said that he would need to use a bit of Adrenalin to wake me up. I was fine and didn’t notice any difference to my heart rate.

[Vanna-C]

Funny thing, it was my dentist who told me that I shouldn’t have the anaesthetic with adrenaline, because of my AF even before I had read the advice on this site. I have been ‘adrenaline’ free ever since, with no problems, no extra pain, no need for extra injections. The only slight problem I have had was a bit of bleeding, or oozing after a visit to the hygienist, as a result of the Rivaroxaban, but that only lasts for about 30 minutes

[Mickey16 in reply to Vanna-C]

My Dentist has asked me to find out about Adrenalin - My EP has moved on and currently I don't have easy access, so I think that from your and others experiences Vanna-C, there is a case for erring on the side of caution. Thank you for your reply.