Description
Novocaine Pharmacodynamics
A local anesthetic with moderate anesthetic activity and a wide range of therapeutic action. Being a weak base, it blocks sodium channels, prevents generation of impulses in the endings of sensitive nerves and impulse guidance along the nerve fibers. It changes the action potential in nerve cell membranes without a pronounced effect on the resting potential. It suppresses not only pain impulses but also impulses of other modality.
During absorption and direct vascular injection into the bloodstream, it reduces excitability of peripheral cholinergic systems, reduces formation and release of acetylcholine from preganglionic endings (has some ganglioblocking effect), eliminates spasm of smooth muscles, reduces excitability of myocardium and motor cortical zones. Eliminates descending inhibitory effects of reticular formation of the brain stem. Inhibits polysynanthic reflexes. In high doses may cause convulsions. It has short anesthetic activity (duration of infiltration anesthesia is 0.5-1 hours).
Indications
Infiltration (including intraosseous) anesthesia;
vagosympathetic cervical, supranephral, circumferential and paravertebral blockades,
Contraindications
Hypersensitivity (including to para-aminobenzoic acid and other local anesthetics);
Children under 12 years of age;
Significant fibrotic changes in tissues.
Caution
Emergency surgery accompanied with acute blood loss; conditions accompanied with decreased hepatic blood flow (e.g., chronic heart failure, liver disease); progression of cardiovascular failure (usually due to development of heart and current blocks); inflammatory diseases or infection of the injection site; pseudocholinesterase deficiency; renal failure; childhood age (12 to 18 years); elderly patients (over 65 years); frail patients.
Administration during pregnancy and lactation
During pregnancy and breast feeding period safety and efficacy of the drug have not been established.
It is possible to use the drug during pregnancy and breast feeding only by physician’s prescription if the expected benefits to the mother exceed the potential risk to the fetus or child.
Directions for use and dosages
- For infiltration anesthesia 0.25% and 0.5% solutions are used; for anesthesia by Vishnevsky method (taut creeping infiltration) 0.125% and 0.25% solutions are used. To reduce absorption and prolong the effect of local anesthesia, 0.1 % solution of epinephrine is used additionally – 1 drop per 2-5-10 ml of procaine solution.
- If paranephral blockade (by A.V. Vishnevsky) is carried out, 50-80 ml of 0.5 % solution or 100-150 ml of 0.25 % solution are injected into perinephric cage, and if vagosympathetic block is carried out, 30-100 ml of 0.25 % solution are injected.
- For circulatory or paravertebral blockade 0.25% or 0.5% solution is injected intradermally.
- The highest doses for infiltration anesthesia in adults: the first single dose at the beginning of surgery – no more than 500 ml of 0.25% solution and 150 ml of 0.5% solution.
- Maximum dose for use in children over 12 years of age is 15 mg/kg.
