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

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.