Local and infiltration anesthesia, medical blockades.
active substance: procaine;
1 ml of solution contains novocaine (procaine hydrochloride) 20 mg;
Excipients: hydrochloric acid, water for injections.
Solution for injection.
Novocain is a local anesthetic with moderate activity and a wide range of therapeutic effects. The mechanism of anesthetic action is associated with the blockade of sodium channels, inhibition of potassium current, competition with calcium surface tension of the phospholipid layer of membranes, inhibition of redox processes and pulse generation. Once in the blood, it reduces the formation of acetylcholine, reduces the excitability of peripheral cholinergic systems, has a blocking effect on the autonomic ganglia, reduces smooth muscle spasms, reduces the excitability of the heart muscle and motor areas of the cerebral cortex.
Conductive, epidural and spinal anesthesia in surgery, urology, ophthalmology, dentistry, otorhinolaryngology, blockade of peripheral nerves and nerve plexuses.
Hypersensitivity to novocaine; cardiogenic shock; severe hypotension; severe forms of chronic heart failure; reduced left ventricular function; atrioventricular block II-III degree; severe bradycardia; Adams-Stokes syndrome; history of seizures caused by the use of novocaine; sinus node weakness syndrome; severe liver dysfunction; hypovolemia; bleeding; myasthenia; infection of the lumbar puncture site; septicemia; purulent process at the injection site; urgent surgical interventions accompanied by acute blood loss. In glaucoma, it is forbidden to administer the drug retrobulbarly.
It is forbidden to use the drug to children.
Use during pregnancy or breastfeeding
Use during pregnancy is possible provided good tolerability.
During breastfeeding, the drug may be used after a careful evaluation of the expected benefits of therapy for the mother and the potential risk to the baby.
When used during childbirth may develop bradycardia, apnea, seizures in the newborn. Use during pregnancy or breastfeeding.
Method of application and dosage
The dose of Novocain usually depends on the type of anesthesia, the degree of vascularization of the tissues, the required depth and duration of analgesia, as well as on the individual characteristics of the patient. The lowest effective dose should be administered.
Recommended doses depending on the type of anesthesia:
- Mandibular – 2% solution 2-3 ml (40-60 mg);
- Infraorbital – 2% solution of 0.5-1 ml (10-20 mg);
- Finger anesthesia (without adrenaline) – 1% solution of 3-4 ml (30-40 mg);
- Paracervical (as a slow 5-minute injection) – 1% solution of 3 ml (in each of the 4 sections) (80-120 mg).
Sterile 0.9% sodium chloride solution should be used to obtain a 1% solution of Novocain.
To perform caudal and lumbar epidural blockade, 15–25 ml of 2% solution should be administered. The maximum volume of a single injection should not exceed 25 ml. Repeated doses, usually less than the initial 2-6 ml, should be administered at intervals of 40-50 minutes.
The maximum single dose for adults is 11 mg / kg body weight, but not more than the maximum total dose of 800 mg. Dosage should be reduced for the elderly, debilitated patients and patients with cardiovascular and / or liver disease.
Overdose is possible only with the use of novocaine in high doses.
Symptoms: pallor of the skin and mucous membranes, dizziness, nausea, vomiting, increased nervous excitability, “cold” sweat, tachycardia, low blood pressure almost to collapse, tremor, convulsions, apnea, methemoglobinemia, respiratory depression, sudden cardiovascular collapse.
The effect on the central nervous system is manifested by feelings of fear, hallucinations, convulsions, motor excitement.
Treatment. In cases of overdose, the drug should be discontinued immediately. During local anesthesia, the injection site can be injected with adrenaline.
General resuscitation measures: inhalation of oxygen, if necessary – artificial lung ventilation. If the seizures last more than 15-20 seconds, they should be stopped by intravenous thiopental (100-150 mg) or diazepam (5-20 mg). In case of arterial hypotension and / or myocardial depression, ephedrine (15–30 mg) should be administered intravenously, in severe cases – detoxification and symptomatic therapy.
If intoxication develops after injection into the muscles of the leg or arm, a tourniquet should be applied immediately to reduce the further flow of the drug into the general bloodstream.
The drug is usually well tolerated, but sometimes the development of the following side effects is possible.
- From the senses: visual and auditory disorders, decreased visual acuity, tinnitus, photophobia, nystagmus.
- From the gastrointestinal tract: nausea, vomiting, involuntary defecation.
- From the kidneys and urinary system: involuntary urination.
- From the nervous system: headache, motor restlessness, irritability, dizziness, drowsiness, weakness, loss of consciousness, convulsions, trismus, tremor, ponytail syndrome (paralysis of the legs, paresthesia), numbness of the tongue and perioral area, respiratory depression, respiratory paralysis muscles, motor and sensory block, return of pain, stable anesthesia, coma.
- From the cardiovascular system: chest pain, increase or decrease in blood pressure, collapse, peripheral vasodilation, decreased cardiac output, bradycardia, arrhythmias, heart block, cardiac arrest.
- From the blood and lymphatic system: methemoglobinemia.
- On the part of the immune system: hypersensitivity reactions, including angioneurotic edema (including laryngeal edema), other anaphylactic reactions (including anaphylactic shock), urticaria (on the skin and mucous membranes).
- From the skin and subcutaneous tissue: itchy skin, skin rashes, dermatitis, peeling skin, eczema, erythema, redness.
- General disorders: hypothermia, increased sweating, back pain.
- Injection site reactions: Treatment of the injection site with disinfectant solutions containing heavy metals increases the risk of local reaction in the form of pain and swelling.
Store in the original package at a temperature not exceeding 25 ° C. Do not freeze.
Keep out of reach of children.