LAUSR

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.