Procaine (Novocain)

Category:

• Local anesthetic

Description:

• Local anesthetic

Indications:

• Infiltration anesthesia

• Peripheral or sympathetic nerve block

• Spinal anesthesia

Contraindications:

• Myasthenia gravis, severe shock, impaired cardiac conduction

• Injection into inflamed or infected tissue

Precautions:

• Pregnancy category C

• Cardiac disease, hyperthyroidism, endocrine disease, liver disease

• Elderly, sulfite sensitivity, use in head and neck area

• Retrobulbar blocks

• Low plasma pseudocholinesterase concentrations

Adverse Reactions (Side Effects):

• CNS: anxiety, disorientation, restlessness, loss of consciousness, seizures, tremors

• CV: bradycardia, cardiac arrest, dysrhythmias, fetal bradycardia, myocardial depression

• EENT: blurred vision, pupil constriction, tinnitus

• RESP: anaphylaxis, respiratory arrest

• SKIN: allergic reactions, burning, edema, rash, tissue necrosis, urticaria  

Dosage:

Administered intravenously, by infiltration

• Adult:   

  • Dose varies with procedure, depth of anesthesia, vascularity of tissues, duration of anesthesia, and condition of patient

  • Infiltration anesthesia: 

    • INJ 350-600mg of 0.25%-0.5%

  • Peripheral nerve block: 

    • INJ up to 200ml of 0.5% or 100ml of 1% or 50ml of 2%