Anesthetics and EDS

This page will hold all the links I can find on the different effects of anesthesia in Ehlers-Danlos syndrome (EDS) and Hypermobility Spectrum Disorder (HSD) patients, both good and bad. No two patients are alike. Nothing below applies to all cases of EDS or HSD. Ever. Last updated 4/5/24.

• Resistance to local anesthesia in people with the Ehlers-Danlos Syndromes presenting for dental surgery 2019 Schubart, Schaefer, Janicki et al
• EDS and Anesthetics via The Reluctant Contortionist 2015
• Local Anesthetic Failure in Joint Hypermobility Syndrome 2005 Hakim, Grahame
• Recommendations for anesthesia and perioperative management in patients with Ehlers-Danlos syndrome(s) 2014 Thomas Wiesmann, Marco Castori, […], and Hinnerk Wulf

Dental anesthesia

Dental Freezing (Numbing) Formula that works great for many patients with CTDs:

1/2 mepiva w/out epi, 1 art w/epi 1:100,000

“art” stands for “articaine”.*
*articaine and bruvidicaine has worked well for some others too

We need low to no epi mixed in or it goes out too fast. (Reference: dental numbing, dental freezing)

I’m adding the Pain and EDS links below too, since they’re related, though I will ultimately give them their own page.

Pain and Hypermobility Disorders of all kinds (HSD, EDS, etc.)

• Pain Management in Patients with Hypermobility Disorders: Frequently Missed Causes of Chronic Pain – Dr. Blustein 2017 via TCAPP
• The Physiologic Effects of Pain on the Endocrine System 2013 Tennant, MD
• Rhode Island Pain Center – Dr. Pradeep Chopra, EDS pain specialist
• Pain Management in Ehlers-Danlos Syndrome – Pradeep Chopra, MD 2015 EDNF pdf
• Pain in Ehlers-Danlos Syndrome is Common, Severe and Associated With Functional Impairment Voormens, Knoop et al 2010 JPMS
• Fibromyalgia – an unrecognized Ehlers-Danlos Syndrome Hypermobile Type? (in French) 2013
• Chronic pain in hypermobility syndrome and Ehlers-Danlos syndrome (hypermobility type): it is a challenge Shepherd, de Vries et al 2015 J of Pain
• EDS and Anesthetics via The Reluctant Contortionist 2015
• Local Anesthetic Failure in Joint Hypermobility Syndrome 2005 Hakim, Grahame
• Small fiber neuropathy is a common feature of Ehlers-Danlos syndromes 2016 Cazzato, Castori et al
• Joint Hypermobility and Joint Hypermobility Syndrome – Alan Pocinki MD 2010 (excellent sort of “cliff notes” to all the issues hypermobility can cause in a body even if the disease name and terminology have changed, the issues have not)
• The Princess in the Tower: Healing Resources for CRPS, Fibro and More… (blog)
• 21 Symptoms Kids With Ehlers-Danlos Syndrome Had That Weren’t “Growing Pains” – 2018 The Mighty
• Your Right to Amend Medical Records via Dysautonomia Dispatch 2018
• Use of complementary therapies for chronic pain management for patients with reported Ehlers-Danlos syndrome, or Hypermobility Spectrum Disorders 2020 Demes, McNair and Taylor
• The Constellation of Chronic Low Back Pain and Other Subjective Symptoms: Does the View Differ from China? 2016 Spine (Phila Pa 1976) Ernest Volinn, Ph.D., Bangxiang Yang, M.D., Nan Chen, M.D., Jian Ying, Ph.D., Jing Lin, M.D., Xiaoming Sheng, PhD, and Yunxia Zuo, M.D., Ph.D.