Question about local anaesethic

[fireheart]

OK, I thought of something while reading a Fratching post.

Both times I've had the Implanon put in, I've had to have the local, usually 1-2 needles worth. After said procedure, I have started shaking quite a bit on the table. Not to the point of seizing, just more like "shivering" type of shaking. Is this normal and totally random question, but if it is normal, why does it happen? I'm just really curious.

[Sapphire Silk]

It's a hard question to answer without knowing exactly what local they used. There are a number of very good local anesthetics.

Your symptoms don't seem to be consistent with what I read are potential side effects of the birth control hormones themselves. So it seems unlikely to be the device . . . but you should mention them to your MD the next time you get your implant replaced. She should know about them.

My best guess is the local contained lidocaine. Lidocaine is an inexpensive, effective, widely used local that in stronger doses is used as an anti arrhythmic medication. The symptoms you describe are common side effects and not usually dangerous (some people may have transient hypotension).

[TheSHAD0W]

That explains it. I started shivering in the dentist's chair after they started on a root canal. I'm pretty sure they used lidocaine as the local anesthetic.

[evilfarmer]

The last time I got my Implanon changed it was Lidocaine they used. It did make my arm feel cold and shiver for a little while. Most locals make that part of me feel really cold, which I guess is due to the numbing.

[Gizmo]

Noted for when I DO go to get my teeth sorted....

[fireheart]

Thanks sapphire, I will bet that it was lido. It hurts like a bitch when they stick the needle in and while it's effective, it's not until AFTER they've put in the implant that I'm shaking on the table.

I'm not due for a changeover for another year or two, so until then I guess I'll find out. I'm actually contemplating having it out when I'm due for the next changeover as I've found that shortly after the introduction of said implant, my depression and anxiety wound up being turned up to eleven.

[LesserSouthernFroglet]

Often local injections are a mixture of the local agent and adrenaline. The adrenaline constricts the blood vessels at the site of the surgery, which both extends the effectiveness of the local, and reduces bleeding at the site.

Lidocaine (usually called Lignocaine in Australia) is a very short-acting local, and is nearly always mixed with adrenaline unless operating on digits or other extremities (the adrenaline can cause the tiny arteries in the fingers to totally constrict, which causes a high risk of gangrene).

'Dental' lidocaine has a much higher dosage of adrenaline for the same volume - 1:80,000 compared to 1:200,000 in regular lidocaine/adrenaline mixes. The adrenaline injected during a cardiac incident is around 1:1,000 for comparison.

I'd bet money on it being the adrenaline that is the problem. It is the drug / hormone which causes the 'fight or flight' response when we get a scare, and usually the aftermath involves the shakes, feeling cold etc.

(ex OR nurse - still remembering the dosages. Oh dear...)

[Sapphire Silk]

Yeah, I thought about the adrenaline possibly being a factor (aka epinepherine). However, I think it unlikely.

Usually the lido/epi mixes are used in highly vascular areas to control bleeding (the epi vasoconstricts blood vessels to do this). The head, most often. The arm isn't so vascular as to make this an issue. When I worked in the ER, we usually used lido/epi on the head. Never on the fingers, and with caution on the lower extremities because the vasoconstriction can cause necrosis in those areas.

Of course, there is no way to know. But the symptoms are explained by the lido alone.

Either way, if the OP gets this done again, she should mention the symptoms to her provider before the med is given, and ideally find out exactly what was used. There are other choices that might not cause those symptoms (like Marcaine, for example).

[wolfie]

Just curious, but for those of us who are subject to drug testing at work, will local anaesthetics of the "caine" family cause a positive result for one of the "big 5" on the standard panel? If so, what documentation do we need to get from the doctor/dentist/etc. who administered it to show that it was a legitimate medical use (which will result in the test, if the "expensive test used if the cheap screen shows positive" reveals concentrations consistent with the documentation, being reported as negative to the employer), and how long do we need to hang onto it (i.e. the residue is metabolized and cleared from the body)?

[Sapphire Silk]

Just curious, but for those of us who are subject to drug testing at work, will local anaesthetics of the "caine" family cause a positive result for one of the "big 5" on the standard panel? If so, what documentation do we need to get from the doctor/dentist/etc. who administered it to show that it was a legitimate medical use (which will result in the test, if the "expensive test used if the cheap screen shows positive" reveals concentrations consistent with the documentation, being reported as negative to the employer), and how long do we need to hang onto it (i.e. the residue is metabolized and cleared from the body)?

There are some drugs that will give surprising false positives on urine drug screens, but honestly I'm not familiar with them all. I've never heard of any of these drugs giving a false positive on a drug test.

If you ever come up positive on a drug test, you should be given an opportunity to explain any over the counter medications or prescription medications you were taking.

If you are on a prescription opiod (that is you have the valid prescription), for example, a positive drug screen is expected and your employer is going to have to prove you've been impaired at work in order to discipline you . . . so don't let your boss (who is probably not well versed in this) bully you.

Different drugs metabolize at different rates; you would have to look up the half life of the drug you're curious about to know. THC stays in the body for up to 30 days, which makes proving impairment on the job impossible . . . but since it's still illegal, companies can have zero tolerance policies.

[wolfie]

If you are on a prescription opiod (that is you have the valid prescription), for example, a positive drug screen is expected and your employer is going to have to prove you've been impaired at work in order to discipline you . . . so don't let your boss (who is probably not well versed in this) bully you.

In my field (trucking), the FMCSA sets the rules. The employer doesn't conduct the test - a stand-alone lab does it. If a legitimately-prescribed drug (such as a local anaesthetic for dental work) would produce a positive result, the worker gives the evidence to the collection site when the sample is taken, and if the 2nd line test after a positive screen shows results consistent with the legitimate prescription the lab reports "negative" to the employer. Also (specific to FMCSA testing), while a legitimately prescribed opiate or opiod would result in "negative" being reported to the employer, the driver is still considered out-of-service due to medical disqualification until they discontinue use.

My specific question was whether the "caine" family (lidocaine, novocaine, etc.) would result in a positive result for cocaine (one of the "big 5", the others being THC, amphetamines, opiates, and barbituates).

[Sapphire Silk]

My specific question was whether the "caine" family (lidocaine, novocaine, etc.) would result in a positive result for cocaine (one of the "big 5", the others being THC, amphetamines, opiates, and barbituates).

I answered it I don't know; I've never heard of any of these drugs doing that but that doesn't mean anything because it's not something I have a lot of experience with.

[Seanette]

OK, I thought of something while reading a Fratching post.

Both times I've had the Implanon put in, I've had to have the local, usually 1-2 needles worth. After said procedure, I have started shaking quite a bit on the table. Not to the point of seizing, just more like "shivering" type of shaking. Is this normal and totally random question, but if it is normal, why does it happen? I'm just really curious.

Sounds like a reaction I get to some local dental anesthetics. I'm told the ones that affect me like that contain epinephrine, so I now ask dentists to use something that doesn't have that ingredient.