Expert: Dr Ian Jackson - please note UK based - 9/17/2009

Question
Can anxiety cause local anaesthetic to not work? Prior to wire needle localization breast biopsy I was given 2 ativan under the tongue at time of needle insertion & then 2 more prior to receiving local anaesthetic for the removal, about 2 hours later. I then received an injection for local anaesthetic for the removal but once the cutting began I could feel it and after 2 more injections of it my Dr. finally gave me versed IV as I could still feel the cutting pain. Thankfully the versed put me right out I guess because I woke up & it was over. Just curious as to why I could still feel cutting pain after all that? Thank-you.

Answer
Shirley
Everyone is different and feels pain in a different way. Also anxiety may have contributed to you interpreting the movement stimulus as pain. Versed does not have any pain control and so the fact that you fell asleep and remember nothing means that the local anaesthetic was working (to some degree) as there is no way they could do that operation just with versed.
So I suspect you may have had heightened sensitivity due to anxiety (which is understandable) and this led to a need for a bit more than just the local anaesthesia.
Hope this helps, I wish you a speedy recovery.
Dr Ian Jackson