Prilocaine (Citanest)

Category:

• Local anesthetic

Description:

• Local amide anesthetic

Indications:

• Dental anesthesia

• Infiltration anesthesia

• Peripheral nerve block

• Local anesthesia

Contraindications:

• Anticoagulant therapy, amide local anesthetic hypersensitivity, coagulopathy

• Intraarterial/intravenous administration, infection, thrombocytopenia

Precautions:

• Pregnancy category B; avoid breastfeeding

• Cardiac disease, AV block, elderly, hepatic disease

• Head and neck anesthesia, myasthenia gravis

• Shock, methemoglobinemia

Adverse Reactions (Side Effects):

• anaphylactoid reactions, anxiety, atrial fibibrillation, AV block, cardiac arrest

• blurred vision, dizziness, drowsiness, nausea, vomiting, PR and QT prolongation

• Pruritis, rash, restlessness, respiratory depression, tremor, urticaria

• Sinus bradycardia, sinus tachycardia

Dosage:

Administered by infiltration or by peripheral block techniques

• Dental anesthesia via infiltration and local anesthesia via peripheral nerve block:

  • Note: Individual variations in onset and duration may occur

  • Regional dosage: 

    • Adult: Initially, 1-2 ml (40-80mg) of a 4% solution injected SQ

    • Child <10 years: Inject not more than 1ml (40mg) of a 4% solution SC

    • Corresponding doses for younger children may be determined by Clark’s rule (wt in pounds X adult dose)/150

• Maximum Dosage:

  • Adult: 

    • 600 mg/dose (8 mg/kg/dose) and no more than 600mg should be administered in any 2 hour period

  • Child 11-12 years: 

    • Max dose info not available

  • Child < 10 years: 

    • 40 mg/dose