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

 

 
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