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

Authors Ayuse T, Kurata S, Ayuse T

Received 19 June 2020

Accepted for publication 6 August 2020

Published 20 August 2020 Volume 2020:13 Pages 99—103


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Stefan Wirz

Terumi Ayuse,1 Shinji Kurata,2 Takao Ayuse1,2

1Nagasaki University Hospital, Department of Special Care Dentistry, Nagasaki, Japan; 2Nagasaki University Hospital, Department of Dental Anesthesiology, Nagasaki, Japan

Correspondence: Takao Ayuse
Nagasaki University Graduate School of Biomedical Science, Department of Translational Medical Sciences, Division of Clinical Physiology, Nagasaki, Japan
Tel +81-95-849-7714
Fax +81-95-849-7715

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

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