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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is There Any Alternate Medicine For Novocain?

I have to have a angiogram done and a stent put in., My question is How will the doctors do this when I have blood pooling when given Novocain which is used at the local insertion sight, and Aspirin causes me extreme stomach pain, nausea, and diarrhea. My Dr. says if the stent goes in I will half to be on aspirin forever. Oh and I flat lined from a sulfite reaction. Sulfite is the preservative in Novocain and other types of these pain meds. Are the any alternative drugs/meds they can use?
Wed, 5 Aug 2015
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Cardiologist 's  Response
Hello. Thank you for your question and welcome to HCM. I understand your concern.

Let us treat the problems one by one. Now, in medicine, every decision is carried out by a doctor who carefully weighs the benefit/risk balance. If a coronary artery narrowing or blockage is left untreated with a stent placement, then that artery will surely totally close and give you a heart attack. This is the primary problem in these cases. In your particular case, you said that you have problems with your stomach. Indeed, aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) irritate the stomach inner lining by blocking an important factor which inhibits the acid production in the stomach (prostaglandins). From now to the end, I will share my and our clinic's experience in these cases. First, I would order an upper gastrointestinal (GI) endoscopy, to see if there is an actual problem in your stomach, such as gastro-oesophageal reflux disease (GERD), chronic gastritis or ulcer. If there is a present inflammation there, I would withhold the procedure, until this inflammation is healed. If there is not, then you can take aspirin and clopidogrel, accompanied, of course, with a stomach mucosa protector (anti-H2 hystamine receptor drugs or protein pump inhibitor (PPI) drugs).

As for the novocain, yes, it contains sulfite derivatives, which can cause allergic reactions, ranging from mild to true, life-threatening, anaphylactic shock. Lidocaine is used in our clinic, which also contains sodium metabisulfite. However, the need for stent placement is critical. So, you would be safe if an anti-allergic reaction protocol is used, which consists on:
- prednisolone 2 x 25 mg (amp), given 13, 7 and 1 hour before the procedure, and
- telfast 1 x 180 mg (tb), given 13 and 1 hour before the procedure.

I hope I was clear, helpful and thorough with my answer. Good luck with the procedure. Best regards.
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Is There Any Alternate Medicine For Novocain?

Hello. Thank you for your question and welcome to HCM. I understand your concern. Let us treat the problems one by one. Now, in medicine, every decision is carried out by a doctor who carefully weighs the benefit/risk balance. If a coronary artery narrowing or blockage is left untreated with a stent placement, then that artery will surely totally close and give you a heart attack. This is the primary problem in these cases. In your particular case, you said that you have problems with your stomach. Indeed, aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) irritate the stomach inner lining by blocking an important factor which inhibits the acid production in the stomach (prostaglandins). From now to the end, I will share my and our clinic s experience in these cases. First, I would order an upper gastrointestinal (GI) endoscopy, to see if there is an actual problem in your stomach, such as gastro-oesophageal reflux disease (GERD), chronic gastritis or ulcer. If there is a present inflammation there, I would withhold the procedure, until this inflammation is healed. If there is not, then you can take aspirin and clopidogrel, accompanied, of course, with a stomach mucosa protector (anti-H2 hystamine receptor drugs or protein pump inhibitor (PPI) drugs). As for the novocain, yes, it contains sulfite derivatives, which can cause allergic reactions, ranging from mild to true, life-threatening, anaphylactic shock. Lidocaine is used in our clinic, which also contains sodium metabisulfite. However, the need for stent placement is critical. So, you would be safe if an anti-allergic reaction protocol is used, which consists on: - prednisolone 2 x 25 mg (amp), given 13, 7 and 1 hour before the procedure, and - telfast 1 x 180 mg (tb), given 13 and 1 hour before the procedure. I hope I was clear, helpful and thorough with my answer. Good luck with the procedure. Best regards.