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%

Source: Operational Medicine 2001, Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300