Procaine

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Procaine Brand Name– Novocain

What is Procaine

Procaine hydrochloride is a short-acting local anesthetic of the ester type used for local and regional anesthesia.

It lacks topical anesthetic activity. Its toxicity is the standard against which others are compared.

Procaine is, however, more likely to cause a hypersensitivity reaction than are amide-type local anesthetics.

Procaine received FDA approval in 1939.

Indications

  1. dental anesthesia
  2. infiltration anesthesia
  3. local anesthesia
  4. peripheral nerve block
  5. regional anesthesia
  6. severe pain
  7. spinal anesthesia
  8. sympathetic nerve block

Side Effects

  1. anaphylactoid reactions
  2. anxiety
  3. arrhythmia exacerbation
  4. back pain
  5. blurred vision
  6. bradycardia
  7. bronchospasm
  8. cardiac arrest
  9. chondrolysis
  10. coma
  11. confusion
  12. decreased uterine contractility
  13. diaphoresis
  14. dizziness
  15. drowsiness
  16. erythema
  17. fecal incontinence
  18. fetal acidosis
  19. fetal bradycardia
  20. fever
  21. headache
  22. hypotension
  23. injection site reaction
  24. meningitis
  25. muscle paralysis
  26. nausea
  27. neonatal depression
  28. paresthesias
  29. pruritus
  30. rash
  31. respiratory arrest
  32. respiratory depression
  33. restlessness
  34. seizures
  35. shivering
  36. sneezing
  37. syncope
  38. tinnitus
  39. tremor
  40. urinary incontinence
  41. urinary retention
  42. urticaria
  43. vomiting
  44. weakness

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • anticoagulant therapy
  • AV block
  • breast-feeding
  • cardiac disease
  • coagulopathy
  • continuous intraarticular infusion administration
  • dehydration
  • eclampsia
  • ester local anesthetic hypersensitivity
  • fetal distress
  • fetal prematurity
  • geriatric
  • head and neck anesthesia
  • hepatic disease
  • hypertension
  • hypotension
  • hypovolemia
  • infection
  • intraarterial administration
  • intrathecal administration
  • intravenous administration
  • labor
  • myasthenia gravis
  • neurological disease
  • obstetric delivery
  • ocular surgery
  • para-aminobenzoic acid, PABA hypersensitivity
  • paracervical nerve block
  • pregnancy
  • pseudocholinesterase deficiency
  • pudendal nerve block
  • QT prolongation
  • shock
  • sulfite hypersensitivity
  • thrombocytopenia

Interactions

  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Propoxyphene
  • Alfentanil
  • Ambenonium Chloride
  • Amyl Nitrite
  • Angiotensin II receptor antagonists
  • Angiotensin-converting enzyme inhibitors
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Oxycodone
  • Atracurium
  • Atropine; Edrophonium
  • Belladonna Alkaloids; Ergotamine; Phenobarbital
  • Belladonna; Opium
  • Benzonatate
  • Bepridil
  • Beta-adrenergic blockers
  • Bromocriptine
  • Brompheniramine; Guaifenesin; Hydrocodone
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Caffeine; Ergotamine
  • Calcium-channel blockers
  • Capreomycin
  • Carbinoxamine; Hydrocodone; Phenylephrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Central-acting adrenergic agents
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Cholinesterase inhibitors
  • Cisatracurium
  • Daratumumab; Hyaluronidase
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Dihydroergotamine
  • Diphenhydramine; Hydrocodone; Phenylephrine
  • Donepezil
  • Donepezil; Memantine
  • Doxacurium
  • Doxazosin
  • Edrophonium
  • Enflurane
  • Eplerenone
  • Epoprostenol
  • Ergoloid Mesylates
  • Ergonovine
  • Ergot alkaloids
  • Ergotamine
  • Etomidate
  • Fentanyl
  • Fospropofol
  • Galantamine
  • General anesthetics
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Halothane
  • Homatropine; Hydrocodone
  • Hyaluronidase
  • Hyaluronidase, Recombinant; Immune Globulin
  • Hydralazine; Isosorbide Dinitrate, ISDN
  • Hydrocodone
  • Hydrocodone; Ibuprofen
  • Hydrocodone; Phenylephrine
  • Hydrocodone; Potassium Guaiacolsulfonate
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hydromorphone
  • Ibuprofen; Oxycodone
  • Iloprost
  • Isoflurane
  • Isosorbide Dinitrate, ISDN
  • Isosorbide Mononitrate
  • Ketamine
  • Levorphanol
  • Loop diuretics
  • Mecamylamine
  • Meperidine
  • Meperidine; Promethazine
  • Methylergonovine
  • Methysergide
  • Minocycline
  • Mivacurium
  • Monoamine oxidase inhibitors
  • Neostigmine
  • Neuromuscular blockers
  • Nitrates
  • Nitroglycerin
  • Oxycodone
  • Oxymorphone
  • Pancuronium
  • Pergolide
  • Phenoxybenzamine
  • Phentolamine
  • Physostigmine
  • Polymyxins
  • Potassium-sparing diuretics
  • Prazosin
  • Procarbazine
  • Propofol
  • Propoxyphene
  • Pyridostigmine
  • Rapacuronium
  • Remifentanil
  • Reserpine
  • Rituximab; Hyaluronidase
  • Rivastigmine
  • Rocuronium
  • Sevoflurane
  • Sparfloxacin
  • Succinylcholine
  • Sufentanil
  • Tacrine
  • Terazosin
  • Thiazide diuretics
  • Trastuzumab; Hyaluronidase
  • Treprostinil
  • Tubocurarine
  • Vasodilators
  • Vecuronium

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