Yes

Local Anesthetic

Produces spinal anesthesia and epidural and peripheral nerve block by injection and infiltration methods

C

Known hypersensitivity to procaine, PABA, parabens, or other ester local anesthetics

Patients with cardiac diseases, hyperthyroidism, or other endocrine diseases may be more susceptible to toxic effects of local anesthetics; some preparations contain metabisulfite

1% to 10%: Local: Burning sensation at site of injection, tissue irritation, pain at injection site

<1%: Aseptic meningitis resulting in paralysis can occur, CNS stimulation followed by CNS depression, chills, discoloration of skin, nausea, vomiting, miosis, tinnitus, anaphylactoid reaction

Treatment is primarily symptomatic and supportive. Termination of anesthesia by pneumatic tourniquet inflation should be attempted when the agent is administered by infiltration or regional injection. Seizures commonly respond to diazepam, while hypotension responds to I.V. fluids and Trendelenburg positioning. Bradyarrhythmias (heart rate <60) can be treated with I.V., I.M., or S.C. atropine 15 mcg/kg. With the development of metabolic acidosis, I.V. sodium bicarbonate 0.5-2 mEq/kg and ventilatory assistance should be instituted.

Decreased effect of sulfonamides with the PABA metabolite of procaine, chloroprocaine, and tetracaine

Decreased/increased effect of vasopressors, ergot alkaloids, and MAO inhibitors on blood pressure when using anesthetic solutions with a vasoconstrictor

Blocks both the initiation and conduction of nerve impulses by decreasing the neuronal membrane's permeability to sodium ions, which results in inhibition of depolarization with resultant blockade of conduction

Onset of effect: Injection: Within 2-5 minutes

Duration: 0.5-1.5 hours (dependent upon patient, type of block, concentration, and method of anesthesia)

Metabolism: Rapidly hydrolyzed by plasma enzymes to para-aminobenzoic acid and diethylaminoethanol (80% conjugated before elimination)

Half-life: 7.7 minutes

Elimination: In urine as metabolites and some unchanged drug

Dose varies with procedure, desired depth, and duration of anesthesia, desired muscle relaxation, vascularity of tissues, physical condition, and age of patient

None reported

If used with a vasoconstrictor, the effects of MAOIs may be enhanced

No information available to require special precautions

This is no longer a useful anesthetic in dentistry because of high incidence of allergic reactions

The purpose of this medication is to reduce pain sensation. Report local burning or pain at injection site. Pregnancy/breast-feeding precautions: Inform prescriber if you are pregnant. Consult prescriber if breast-feeding.

Prior to instillation of anesthetic agent, withdraw plunger to ensure needle is not in artery or vein; resuscitative equipment should be available when local anesthetics are administered

Injection, as hydrochloride: 1% [10 mg/mL] (2 mL, 6 mL, 30 mL, 100 mL); 2% [20 mg/mL] (30 mL, 100 mL); 10% (2 mL)

Altman RS, Smith-Coggins R, and Ampel LL, "Local Anesthetics," Ann Emerg Med, 1985, 14(12):1209-17.

Hart D, "Psychotic Reaction to Procaine," J Emerg Nurs, 1984, 10(1):9-10.

Wikinski JA, Usubiaga JE, and Wikinski RW, "Cardiovascular and Neurological Effects of 4000 mg of Procaine," JAMA, 1970, 213(4):621-3.