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%

 
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