Successful Dental Treatments Using Procaine Hydrochloride in a Patient Afraid of Local Anesthesia but Consenting for Allergic Testing with Lidocaine: A Case Report

Abstract

Background

We report a case in which effective dental anesthetic management was achieved using procaine hydrochloride for a patient who had an unknown history of allergic reactions to lidocaine.

Case Presentation

Because the patient refused to undergo screening tests using any of the amide-type local anesthetics because of her extreme fear against local anesthetics that she had been administered previously, procaine hydrochloride, which is an ester-form local anesthetic, was the only agent to be tested on this patient at the department of dermatology. Consequent to a negative allergy test, we performed complete dental treatment using procaine hydrochloride after additional chairside drug challenge tests using minimum test dose under vital sign monitoring.

Conclusion

The success of dental treatment using procaine hydrochloride may have relieved the patient’s fear of local anesthesia. We discuss an important aspect of treatment planning for patients with a history of complications during local anesthesia.

Keywords:

• allergic reaction
• amide-type local anesthesia
• procaine hydrochloride
• dental fear
• dental anxiety
• local anesthesia
• complication

Disclosure

The authors report no conflicts of interest for this work.