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Does Anyone Know What Anesthesia PANDAS Kids Can Use?


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Nancy,

 

The anesthesia I always ask for is propofol. It gives you a good sleep and is quick to get out of your system. Here is a good article written by a nurse who works in anesthesiology and she is the parent of a child with ASD. She addresses the immune system, methylation, etc.

http://www.autism.com/index.php/pro_anesthesia

 

Wishing your DD a successful surgery and a speedy recovery!

 

Nancy

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NancyD - thanks for this link - it's exactly what I've been looking for. DD needs two baby teeth extracted and while I've known nitrous oxide was contraindicated (due to MTHFR), I didn't know what to ask about as an alternative. I'd mentioned the issue to the orthodontist 6 months ago and he had never heard of MTHFR so I knew I was going to have to be the driver. This gives me a professional article to hand to him instead of sounding like one of "those" moms. DD's been put under before for an endoscope and did fine but this was before we knew about MTHFR and I'm guessing it was propofol, with Versed administered beforehand. She handled it fine but since DDS still rely heavily on nitrous oxide, this is really helpful info.

 

I'm thinking since she only needs to be out for a few minutes for two baby teeth extractions, Versed seems like it should be a good option. Do you have any thoughts?

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I don't know if this is all related but it was right after DS had dental surgery for a baby molar extraction that this PANS started within the week. They used midazolam (which I think is Versed.) Was it the antibiotic they used for the abscess prior to the surgery that woke up his lyme and pans, or was it the sedation that "activated" something, I'm not sure. We do know now that he has a MTHFR mutation but I believe that might be specific to nitrous?

 

A few months later they had to do another extraction and they used a local anaesthetic - he had no issues.

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lfran - I don't think something like Novocain would do it for DD. She will pysche herself out before her butt even lands in the chair. She's going to need something not just for pain but to keep her sedated or very very relaxed for the extraction. She gets so freaked even for a cleaning that when she needed a small cavity filled, they did it quickly without novocain or any pain relief before she had time to know what was coming. Allowed to remain conscious, she wouldn't be able to sit thru a procedure like an extraction.

 

But for "normal" people with MTHFR but not these severe anxieties, I think Novocain would be ok for routine procedures like fillings or crowns. FWIW, Novocain always makes me feel very racy and anxious for the first 5-10 min after the shot. I hate it. I mentioned it to my dentist and he said his brother had the same issue. Novocain has a lot of norepinephrine and he can't handle it. So there's some alternative that doesn't use norepinephrine - you need to use more of it and sometimes you need a second shot but it doesn't cause that horrible racy feeling. Forget what it's called but it's now in my chart to use this instead of novocain.

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Laura, here are two journal articles I bookmarked that I gave to DD's oral surgeon.

 

http://mobile.journals.lww.com/anesthesiology/_layouts/oaks.journals.mobile/articleviewer.aspx?year=2012&issue=07000&article=00011

 

http://mobile.journals.lww.com/anesthesiology/_layouts/oaks.journals.mobile/articleviewer.aspx?year=2012&issue=07000&article=00006

 

DD used Versed for a procedure and had no problem.

 

Nancy

 

 

NancyD - thanks for this link - it's exactly what I've been looking for. DD needs two baby teeth extracted and while I've known nitrous oxide was contraindicated (due to MTHFR), I didn't know what to ask about as an alternative. I'd mentioned the issue to the orthodontist 6 months ago and he had never heard of MTHFR so I knew I was going to have to be the driver. This gives me a professional article to hand to him instead of sounding like one of "those" moms. DD's been put under before for an endoscope and did fine but this was before we knew about MTHFR and I'm guessing it was propofol, with Versed administered beforehand. She handled it fine but since DDS still rely heavily on nitrous oxide, this is really helpful info.

 

I'm thinking since she only needs to be out for a few minutes for two baby teeth extractions, Versed seems like it should be a good option. Do you have any thoughts?

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Laura, the reason you felt racey after the novacaine was probably due to epinephrine. I can't take anything with epinephrine in it so I always ask for novacaine without it.

 

Nancy

 

lfran - I don't think something like Novocain would do it for DD. She will pysche herself out before her butt even lands in the chair. She's going to need something not just for pain but to keep her sedated or very very relaxed for the extraction. She gets so freaked even for a cleaning that when she needed a small cavity filled, they did it quickly without novocain or any pain relief before she had time to know what was coming. Allowed to remain conscious, she wouldn't be able to sit thru a procedure like an extraction.

 

But for "normal" people with MTHFR but not these severe anxieties, I think Novocain would be ok for routine procedures like fillings or crowns. FWIW, Novocain always makes me feel very racy and anxious for the first 5-10 min after the shot. I hate it. I mentioned it to my dentist and he said his brother had the same issue. Novocain has a lot of norepinephrine and he can't handle it. So there's some alternative that doesn't use norepinephrine - you need to use more of it and sometimes you need a second shot but it doesn't cause that horrible racy feeling. Forget what it's called but it's now in my chart to use this instead of novocain.

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