Novocain 0.25 instructions for use. Novocain - instructions for use. Airway obstruction

Tradename: Novocaine

International non-proprietary name:

procaine

Dosage form:

injection.

Compound:

1 ml of the solution contains 5 mg or 20 mg of procaine hydrochloride as an active substance and excipients - a solution of hydrochloric acid 0.1 m, water for injection.
Description: clear colorless or slightly colored liquid.

Pharmacotherapeutic group:

local anesthetic.
ATX code:[ N01BA02 ]

Pharmacodynamics
A local anesthetic with moderate anesthetic activity and a wide range of therapeutic effects. Being a weak base, it blocks Na + channels, prevents the generation of impulses at the endings of sensory nerves and the conduction of impulses along nerve fibers. Changes the action potential in the membranes of nerve cells without a pronounced effect on the resting potential. Suppresses the conduction of not only pain, but also impulses of other modalities. With absorption and direct intravascular administration, it reduces the excitability of peripheral cholinergic receptors, reduces the formation and release of acetylcholine from preganglionic endings (it has some ganglion-blocking effect), eliminates spasm of smooth muscles, and reduces the excitability of the myocardium and motor areas of the cerebral cortex. When administered intravenously, it has an analgesic, hypotensive and antiarrhythmic effect (increases the effective refractory period, reduces excitability, automatism and conductivity), in large doses it can disrupt neuromuscular conduction. Eliminates the descending inhibitory influences of the reticular formation of the brain stem. Inhibits polysynaptic reflexes. In high doses, it can cause convulsions. It has a short anesthetic activity (the duration of infiltration anesthesia is 0.5-1 hour).

Pharmacokinetics
Undergoes complete systemic absorption. The degree of absorption depends on the site (the degree of vascularization and the rate of blood flow in the injection site), the route of administration and the total dosage. It is rapidly hydrolyzed by plasma and liver esterases with the formation of 2 main pharmacologically active metabolites: diethylaminoethonol (has a moderate vasodilating effect) and para-aminobenzoic acid (it is a competitive antagonist of sulfanilamide chemotherapy drugs and can weaken their antimicrobial effect). The half-life is 30-50 seconds, in neonotal period -54-114 s. It is excreted mainly by the kidneys in the form of metabolites, no more than 2% is excreted unchanged.

Indications for use

• infiltration, conduction and epidural anesthesia;
• vagosympathetic cervical, pararenal, circular and paravertebral blockades.

Contraindications
Hypersensitivity (including to para-aminobenzoic acid and other local anesthetics), children under 12 years of age.
For anesthesia by the creeping infiltrate method: pronounced fibrotic changes in the tissues. For epidural anesthesia: atrioventricular block, marked decrease in blood pressure, shock, infection of the lumbar puncture site, septicemia.

Carefully
Emergency operations accompanied by acute blood loss; conditions accompanied by a decrease in hepatic blood flow (for example, in chronic heart failure, liver diseases); pseudocholinesterase deficiency; kidney failure; children's age from 12 to 18 years and in elderly patients (over 65 years); weakened patients; pregnancy and childbirth.

Dosage and administration
For infiltration anesthesia: use 0.25-0.5% solutions; for anesthesia according to the Vishnevsky method (tight creeping infiltration) - 0.125-0.25% solutions. To reduce absorption and prolong the action during local anesthesia, an additional 0.1% solution of epinephrine hydrochloride is administered - 1 drop per 2-5-10 ml of procaine solution. Higher doses for infiltration anesthesia for adults: the first single dose at the beginning of the operation - no more than 500 ml for a 0.25% solution or 150 ml for a 0.5% solution. In the future, during each hour of the operation - no more than 1000 ml for a 0.25% solution or 400 ml for a 0.5% solution.
The maximum dose for use in children over 12 years old is 15 mg / kg.
For conduction anesthesia: 1-2% solutions (up to 25 ml); for epidural - 2% solution (20-25 ml). With pararenal blockade (according to A.V. Vishnevsky), 50-80 ml of a 0.5% solution or 100-150 ml of a 0.25% solution are injected into the perirenal tissue, and with vagosympathetic blockade - 30-100 ml of a 0.25% solution.
For circular or paravertebral blockades, a 0.25% - 0.5% solution is injected intradermally.

Side effect
Headache, dizziness, drowsiness, weakness, cauda equina syndrome, convulsions, increased or decreased blood pressure, collapse, peripheral vasodilation, bradycardia, arrhythmia, chest pain, involuntary urination or defecation, impotence, methemoglobinemia, allergic reactions (up to anaphylactic shock).
From the digestive system: nausea, vomiting.
Other: return of pain, persistent anesthesia, hypothermia, with anesthesia in dentistry: numbness and paresthesia of the lips and tongue, prolongation of anesthesia.

Overdose
Symptoms: pale skin and mucous membranes. Dizziness, nausea, vomiting, "cold" sweat, increased severity of side effects. Treatment: maintaining adequate pulmonary ventilation, detoxification and sympathetic therapy.

Interaction
Enhances the inhibitory effect on the central nervous system of general anesthesia, hypnotics and sedatives, narcotic analgesics and tranquilizers.
When using local anesthetic drugs for spinal and epidural anesthesia with guanadrel, guanethidine, mecamylamine, trimethaphan, the risk of a sharp decrease in blood pressure and bradycardia increases.
Anticoagulants (ardeparin, dalteparin, danaparoid, enoxaparin, heparin, warfarin) increase the risk of bleeding. When treating the injection site of a local anesthetic with disinfectant solutions containing heavy metals, the risk of developing a local reaction in the form of pain and swelling increases.
Use with MAO inhibitors (furazolidone, procarbazine, selegeline) increases the risk of hypotension.
Strengthen and lengthen the action of muscle relaxants.
When prescribing procaine together with narcotic analgesics, an additive effect is noted, which is used during spinal and epidural anesthesia, while respiratory depression is enhanced.
Vasoconstrictors (epinephrine, methoxamine, phenylephrine) prolong the local anesthetic effect.
Procaine reduces the antimyasthenic effect of drugs, especially when used in high doses, which requires additional correction in the treatment of myasthenia gravis.
Cholinesterase inhibitors (anti-myasthenic JIC, cyclophosphamide, demecarine, ecothiophate, thiotepa) reduce the metabolism of procaine.
The procaine metabolite (para-aminobenzoic acid) is a sulfonamide antagonist.

special instructions
Patients require control of the functions of the cardiovascular, respiratory and central nervous systems. It is necessary to cancel MAO inhibitors 10 days before the introduction of a local anesthetic. During the period of treatment, it is necessary to refrain from driving vehicles and engaging in potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions. Before use, mandatory testing for individual sensitivity to the drug. It should be borne in mind that when conducting local anesthesia using the same total dose, the toxicity of novocaine is the higher, the more concentrated the solution is used. Not absorbed from mucous membranes; does not provide superficial anesthesia when applied to the skin.

Release form:

solution for injections 5 mg/ml, 20 mg/ml. 2.5ml-20mg/ml, 5.10ml - 5mg/ml in neutral glass ampoules. 10 ampoules with instructions for use in a pack or cardboard box. 5 ampoules in a blister pack. 2 blister packs in a cardboard box. An ampoule knife or a scarifier or an ampoule ceramic scarifier is put into each box. When packing ampoules with a break point or ring, an ampoule knife or a scarifier is not included.

Storage conditions
List B. In a dark place.

Best before date
3 years. Do not use after the expiry date stated on the packaging.

Terms of dispensing from pharmacies
Released by prescription.

Manufacturer / Organization accepting claims:
FSUE "Armavir Biological Factory"
352212. Russia, Krasnodar Territory, Novokubansky district, Progress settlement, st. Mechnikova, 11

Tradename

Novocaine

International non-proprietary name

Dosage form

Solution for injection 0.5% 10 ml

Compound

1 ml of solution contains

active substance- procaine hydrochloride 5.0 mg,

Excipients: 0.1 M hydrochloric acid, water for injection.

Description

Clear, colorless or slightly yellowish liquid.

Pharmacotherapeutic group

Anesthetics. Local anesthetics. Esters of aminobenzoic acid. Procaine

ATX code N01BA02

Pharmacological properties

Pharmacokinetics

Procaine undergoes complete systemic absorption, the extent of which depends on the site, route of administration (especially on vascularization and blood flow velocity in the injection site) and the dose of the drug (amount and concentration).

It is rapidly hydrolyzed by plasma and liver esterases to form two main pharmacologically active metabolites: diethylaminoethanol (has a moderate vasodilating effect) and para-aminobenzoic acid.

The half-life (T1/2) is 40.0±9.0 sec. It is excreted mainly by the kidneys in the form of metabolites, no more than 2% is excreted unchanged.

Pharmacodynamics

A local anesthetic with moderate anesthetic activity and a wide range of therapeutic effects. Being a weak base, it blocks Na + channels, prevents the generation of impulses at the endings of sensory nerves and the conduction of impulses along nerve fibers. It changes the action potential in the membranes of nerve cells without a pronounced effect on the resting potential. It suppresses the conduction of not only pain, but also impulses of a different modality. It has a short anesthetic activity (the duration of infiltration anesthesia is 0.5-1 hour).

With absorption and direct intravascular administration, it reduces the excitability of peripheral cholinergic receptors, reduces the formation and release of acetylcholine from preganglionic endings (it has some ganglion-blocking effect), eliminates spasm of smooth muscles, and reduces the excitability of the myocardium and motor areas of the cerebral cortex. When administered intravenously, it has an analgesic, hypotensive and antiarrhythmic effect (increases the effective refractory period, reduces excitability, automatism and conductivity), in large doses it can disrupt neuromuscular conduction. Eliminates the descending inhibitory influences of the reticular formation of the brain stem and polysynaptic reflexes.

Indications for use

For local anesthesia (infiltration, conduction, epidural,

epidural, spinal - subarachnoid, intraosseous)

- to blockade ( vagosympathetic and pararenal blockade,

paravertebral blockade for eczema, neurodermatitis, sciatica)

Dosage and administration

The dose and concentration of the Novocain solution depend on the nature of the surgical intervention, the method of application, the condition and age of the patient,

The drug is used intradermally, intramuscularly, intravenously.

For local anesthesia

For infiltration anesthesia use 0.25% - 0.5% solutions (no more than 1 g for a single injection); for anesthesia by the method of tight creeping infiltration of tissues (according to A.V. Vishnevsky) - 0.125% - 0.25% solutions; for conduction, epi- and epidural anesthesia - 2% solution of 20-25 ml; for spinal anesthesia - 2% solution of 5 ml.

For infiltration anesthesia, the following maximum doses are established (for adults): the first single dose at the beginning of the operation is not more than 1.25 g (500 ml of a 0.25% solution) or 0.75 g (150 ml of a 0.5% solution). In the future, during each hour of the operation - no more than 2.5 g (1000 ml of a 0.25% solution) or 2 g (400 ml of a 0.5% solution) (up to 0.5 g once without adrenaline and 1 g with adrenaline) .

To reduce absorption and prolong the action of Novocaine, it is used in conjunction with a 0.1% solution of adrenaline, which is added aseptically at the rate of 1 drop per 2-5 ml of Novocaine solution.

It is possible to use the drug for intraosseous anesthesia - 0.25% solution of 50-150 ml.

For the blockade

With paravertebral blockade for eczema and neurodermatitis, intradermal injections of 0.25% 70-100 ml of Novocaine solution are recommended in the projection zone of sensitive nerve trunks.

With pararenal blockade (according to A.V. Vishnevsky), 50-80 ml of a 0.5% solution or 100-150 ml of a 0.25% solution of Novocaine are injected into the perirenal tissue.

With vagosympathetic blockade - 30-100 ml of a 0.5% solution of Novocaine.

Maximum doses of Novocain(for adults): when administered intramuscularly, a single dose is 0.1 g; when administered intravenously, a single dose is 0.05 g; the daily dose for parenteral administration is 0.1 g.

If it is necessary to use lower concentrations of Novocain (0.125% or 0.25%), the drug is diluted with a sterile isotonic sodium chloride solution to the required concentration before use.

Intravenous administration is carried out slowly, in isotonic sodium chloride solution.

Doses in pediatric practice are determined depending on body weight, but not more than 15 mg/kg of body weight.

Side effects

Headache, dizziness, weakness, drowsiness

Nausea, vomiting

Arterial hypotension, collapse, bradycardia, chest pain

Visual and auditory disturbances, nystagmus

Tremor, seizures

Methemoglobinemia

Allergic reactions (dermatitis, urticaria, pruritus, erythema,

angioedema, anaphylactic shock)

Contraindications

Hypersensitivity to procaine and drug components

Severe fibrotic changes in tissues (for anesthesia by

creeping infiltrate)

Purulent process at the injection site

Emergency operations accompanied by acute blood loss

myasthenia gravis

Arterial hypotension

Children's age up to 12 years

Drug Interactions

When administered intravenously, Novocain enhances the inhibitory effect on the central nervous system of general anesthesia, hypnotics, sedatives, narcotic analgesics and tranquilizers.

When prescribing the drug together with narcotic analgesics, an additive effect is noted, which is used in spinal and epidural anesthesia, while respiratory depression increases.

Vasoconstrictors (epinephrine, methoxamine, phenylephrine) lengthen the local anesthetic effect of Novocain.

The drug prolongs the neuromuscular blockade caused by suxamethonium, since both drugs are hydrolyzed by plasma cholinesterase.

Novocaine enhances and prolongs the action of muscle relaxant drugs.

Novocaine reduces the antimyasthenic effect of drugs, especially when used in high doses, which requires additional correction in the treatment of myasthenia gravis.

Cholinesterase inhibitors (antimyasthenic drugs, cyclophosphamide, demecarine, ecothiophate, thiotepa) reduce the metabolism of Novocaine, so their combined administration is not recommended.

Anticoagulants (ardeparin, dalteparin, danaparoid, enoxaparin, heparin, warfarin) when used together with Novocaine increase the risk of bleeding.

Use with MAO inhibitors (furazolidone, procarbazine, selegiline) increases the risk of hypotension, so they should be canceled 10 days before local anesthetic.

When using Novocain with guanadrel, guanethidine, mecamylamine, trimethaphan, the risk of a sharp decrease in blood pressure and bradycardia increases.

The para-aminobenzoic acid metabolite of Novocaine is a competitive antagonist of sulfonamides and can weaken their antimicrobial effect, therefore, the simultaneous use of these drugs is not recommended.

When processing the injection site of Novocaine with disinfectant solutions containing heavy metals, the risk of developing a local reaction in the form of pain and swelling increases.

special instructions

Novocaine is generally well tolerated, but it can cause side effects and should be used with caution in all routes of administration. Severe hypotension is sometimes noted, requiring the appointment of sympathomimetics.

The drug is used with caution in emergency operations complicated by acute blood loss, conditions accompanied by a decrease in hepatic blood flow, progression of cardiovascular insufficiency, inflammatory diseases or infection of the injection site, pseudocholinesterase deficiency, renal failure, in elderly patients over 65 years of age, seriously ill, debilitated patients.

During anesthesia, it is necessary to monitor the vital

important bodily functions.

Before applying the anesthetic, it is necessary to conduct tests on

individual sensitivity to the drug.

When conducting local anesthesia when using the same total dose, the toxicity of Novocain is the higher, the more concentrated the solution used is.

The drug is not absorbed from the mucous membranes, therefore it is not

provides superficial anesthesia when applied to the skin.

The period of pregnancy and lactation

During pregnancy and lactation, the drug should be used with extreme caution, according to absolute indications.

Features of the influence of the drug on the ability to drive a vehicle or potentially dangerous mechanisms

Given the side effects of the drug, care should be taken when driving a vehicle or potentially dangerous mechanisms

Overdose

Symptoms: pallor of the skin, dizziness, nausea, vomiting, "cold" sweat, excitation or depression of the central nervous system, blurred vision, tremor, convulsions, respiratory depression, bradycardia, decreased cardiac output, collapse, coma.

Treatment: maintenance of pulmonary ventilation, detoxification and symptomatic therapy.

Release form and packaging

10 ml in neutral glass ampoules.

Each ampoule is labeled with label paper or writing paper, or the text is applied directly to the ampoule with gravure printing ink for glass products.

5 ampoules are packed in a blister pack made of PVC film and aluminum foil.

1 contour package, together with the approved instructions for medical use in the state and Russian languages, is placed in a pack of boxed cardboard or chrome-ersatz. An ampoule scarifier is put into each pack.

When packing ampoules with notches, rings and dots, scarifiers are not included.

It is allowed to place blister packs (without investing in a pack of cardboard) into boxes made of boxed or corrugated cardboard. Instructions for medical use in the state and Russian languages ​​are included in each box according to the number of packages.

Storage conditions

In a place protected from light, at a temperature not exceeding 250C.

Keep out of the reach of children!

Shelf life

Do not use after expiration date

Terms of dispensing from pharmacies

On prescription

Manufacturer

Shymkent, st. Rashidova, 81

Registration certificate holder

Chimpharm JSC, Republic of Kazakhstan

Address of the organization hosting on the territory of the Republic of Kazakhstan claims from consumers on the quality of products (goods)

Chimpharm JSC, Republic of Kazakhstan,

Shymkent, st. Rashidova, 81

Phone number 7252 (561342)

Fax number 7252 (561342)

E-mail address [email protected]

Attached files

659463161477976539_en.doc	70.5 kb
890568601477977695_kz.doc	93.5 kb

Compound

Active ingredient: Procaine.

pharmachologic effect

Local anesthetic. Violates the generation and conduction of nerve impulses mainly in non-myelinated fibers. Antiarrhythmic action is associated with an increase in the effective refractory period, a decrease in myocardial excitability and automatism. Poorly absorbed through mucous membranes. When administered parenterally, it is well absorbed, rapidly hydrolyzed in the bloodstream. Most of the drug is excreted in the urine. When absorbed or directly injected into the blood, it reduces the formation of acetylcholine and the excitability of cholinergic systems, has a ganglioblocking effect, reduces spasm of smooth muscles, and inhibits the excitability of the myocardium and motor areas of the cerebral cortex. It has analgesic and anti-shock activity, hypotensive and antiarrhythmic action. Eliminates the descending inhibitory influences of the reticular formation of the brain stem. Inhibits polysynaptic reflexes. In high doses, it can cause convulsions. It has a short anesthetic activity (the duration of infiltration anesthesia is 0.5-1 hour). It is effective (when administered intramuscularly) in elderly patients in the early stages of diseases associated with functional disorders of the central nervous system (hypertension, spasms of the coronary vessels and cerebral vessels, etc.). Not absorbed from mucous membranes; does not provide surface anesthesia.

Indications for use

Local anesthesia: infiltration, conduction, epidural and spinal; vagosympathetic and pararenal blockade; potentiation of the action of narcotic drugs during general anesthesia; pain syndrome of various origins (including with peptic ulcer of the stomach and duodenum); spasms of blood vessels, neurodermatitis, hemorrhoids, nausea.

Contraindications

Hypersensitivity.

Side effect

Arterial hypotension, dizziness, weakness, allergic reactions (anaphylactic shock is possible).

Interaction

Enhances the effect of narcotic drugs.

Overdose

When used in high doses, excessive absorption is possible, accompanied by nausea, vomiting, sudden cardiovascular collapse, increased nervous excitability, tremors and convulsions, respiratory depression. Treatment: general resuscitation measures. In case of development of intoxication after injection into the muscles of the arm or leg, an urgent application of a tourniquet is recommended to reduce the further entry of the drug into the general circulation.

Method of application and dosage

Infiltration anesthesia - 0.25-0.5% solutions - tight creeping infiltration - 0.125-0.25% solutions - conduction anesthesia - 1-2% solutions - epidural anesthesia - 2% solution (20-25 ml) - spinal anesthesia - 5 % solution (2-3 ml) For circular and paravertebral blockade in eczema, neurodermatitis, sciatica, etc., intradermal injections of 0.25-0.5% solution are used. For anesthesia of the mucous membranes, 10-20% novocaine solutions are used. With pararenal blockade, 50-80 ml of a 0.5% solution or 100-150 ml of a 0.25% solution of novocaine are injected, with vagosympathetic blockade, 30-100 ml of a 0.25% solution. With atrial fibrillation in / in a 0.25% solution of 2-5 ml to 4-5 ml. With local anesthesia, the concentration of novocaine solution is determined individually. To eliminate the pain syndrome, it is used in / m, in / in. 0.25-0.5% solutions from 1 to 10-15 ml are injected into the vein. In case of hypertension, atherosclerosis, spasms of the coronary vessels and cerebral vessels, a 2% solution of 5 ml is injected intramuscularly 3 times a week, the course is 12 injections. For infiltration anesthesia, the highest single doses (for adults): The first single dose at the beginning of the operation is not higher than 1.25 g (500 ml of a 0.25% solution) and 0.75 g (150 ml of a 0.5% solution). In the future, during each hour of the operation - no more than 2.5 g (1000 ml of a 0.25% solution) and 2 g (400 ml of a 0.5% solution). The highest single doses when injected into the muscles of a 2% solution - 0.1 g (5 ml), when injected into a vein of a 0.25% solution - 0.05 g (20 ml). The highest daily dose when injected into muscles and veins is 0.1 g.

special instructions

The drug Novocain 0 25 is used in medicine for local anesthesia and various blockades. The drug has a moderate anesthetic effect, so it can be used for hemorrhoids.

Composition and action of Novocaine hemorrhoids

Active ingredient: novocaine (procaine hydrochloride) - 0.25 g in 100 ml.

Auxiliary components: hydrochloric acid solution 0.1 M, water for injection.

Due to its analgesic, vasodilating and antispasmodic action, the drug is used during local anesthesia in the treatment of hemorrhoids.

Release form Novocaine 0 25

Solution for injection in the form of a clear, colorless or yellowish liquid is available in ampoules of 5 and 10 ml.

Pharmacological properties

Pharmacokinetics

The drug enters the body, where it breaks down into metabolites through the action of blood and tissue esterases. The excretion of metabolic products formed as a result of hydrolysis is carried out by the kidneys.

Pharmacodynamics

The drug has a moderate anesthetic effect, blocks the occurrence and conduction of impulses along the nerve fibers.

When the drug is absorbed into the blood, CNS function is inhibited, smooth muscle fibers relax, and blood pressure decreases. Novocaine has a ganglioblocking, antiarrhythmic and anesthetic effect. The drug is relatively safe and low-toxic, while it has an extensive medicinal effect.

What helps Novocain 0 25

Novocaine hydrochloride injections are used for local anesthesia and for various blockades in the treatment of eczema, neurodermatitis, sciatica. The drug is used in the treatment of diseases of the gastrointestinal tract as an anesthetic for peptic ulcer of the stomach and duodenum, hemorrhoids. In otorhinolaryngology, it is used to treat otitis in the form of drops. The action of Novocain is aimed at relieving spasms of peripheral vessels and normalizing blood circulation. It is also used as an adjunct to general anesthetics to enhance their effectiveness.

Is it possible to take Novocain 0 25 with hemorrhoids

It can be used in proctology in the treatment of hemorrhoids for local anesthesia.

Chronic

For the treatment of chronic hemorrhoids, lotions and suppositories with novocaine are used as a local anesthetic. In this case, it is applied to the affected area.

With an exacerbation

In acute hemorrhoids, accompanied by prolapse and necrosis of compressed hemorrhoids, novocaine blockades are used.

With an intense pain syndrome during an exacerbation of hemorrhoids, pararectal novocaine blockade is used, which is performed by an experienced proctologist in a hospital.

For its implementation, the patient is in the supine position with legs raised and fixed. Infiltration anesthesia is carried out as follows: the solution is injected into 4 points around the anus. Then Novocaine is injected into the area near the rectum where the knot or crack is located. This procedure can be performed both as an independent type of conservative treatment, and in preparation for surgery and during the surgical intervention itself.

Application and dosage of Novocaine

For local anesthesia, the dosage is selected based on the concentration of the active substance in the solution. Also, when calculating the dose, such data as the nature of the surgical intervention, the method of administration, the condition and age of the patient are taken into account.

For intramuscular injection, the maximum single dose is 0.1 g, for intravenous administration - 0.05 g; the daily dose for parenteral administration is 0.1 g. The dose of the drug for children is calculated depending on the weight of the child and is a maximum of 15 mg per 1 kg of body weight.

How to breed

Novocaine 0.25% can be used in its pure form. If the use of the drug at a lower concentration is required, it is recommended to dilute the agent with sterile saline until the required concentration is reached.

In order to reduce the absorption rate and increase the duration of action, Novocaine is used with a 0.1% solution of adrenaline (1 drop of adrenaline per 2-5 ml of procaine).

How to inject Novocain

When performing pararenal blockade according to Vishnevsky, the introduction of 100-150 ml of a 0.25% solution of Novocaine into the perirenal tissue is indicated.

For infiltration anesthesia, a single dose at the beginning of the operation is a maximum of 1.25 g of a 0.25% solution (500 ml). Then, a maximum dose of 2.5 g of 0.25% Novocaine (1000 ml) per hour is administered.

With intraosseous anesthesia, 50-150 ml of a 0.25% solution is used.

Paravertebral blockade is indicated for eczema and neurodermatitis. Perform intradermal injections of 70-100 ml of 0.25% procaine in the area where sensitive nerve trunks are projected.

Intravenous administration is carried out on an isotonic NaCl solution at a slow pace.

With a disease such as arthrosis, the medicine is applied to the joint area of ​​the affected limb.

Is it drinkable

The medicinal solution is not indicated for oral administration.

How long does it take to work

The analgesic effect occurs quickly - 3-5 minutes after the administration of the drug, is characterized by a feeling of numbness and loss of sensitivity in the area of ​​anesthesia.

How long does it work

It has a short anesthetic effect (the duration of the effect with infiltration anesthesia is about 0.5-1 hour).

Contraindications

Novocaine hydrochloride is not recommended for use in case of hypersensitivity to the components of the drug, purulent inflammation at the injection site, myasthenia gravis, arterial hypotension, heart disease. Also, contraindications to the use of the drug are surgical procedures, accompanied by acute blood loss and intense fibrotic changes in the tissues.

Does the drug cause side effects

Novocaine has a high safety profile and low toxicity, and is well tolerated. Sometimes there may be such side effects:

1. Violation of the nervous system: headache, dizziness, general weakness, lethargy, drowsiness, fainting, convulsions, tremors, auditory and visual abnormalities, nystagmus, cauda equina syndrome (paresthesia, paralysis of the lower extremities), respiratory paralysis, stable anesthesia. There may also be conditions accompanied by increased nervous excitability.
2. Cardiovascular disorders: increase or decrease in blood pressure, expansion of peripheral vessels, cardiac arrhythmias, slowing of heart rate (bradycardia), collapse, chest pain.
3. Urinary system disorders: involuntary or frequent urination.
4. Disorders of the gastrointestinal tract: nausea, vomiting, diarrhea, involuntary defecation.
5. Blood pathologies: methemoglobinemia.
6. Immune changes: allergic reactions, rashes, itching and burning of the skin, dermatitis, dryness and peeling of the skin, anaphylactic shock, angioedema, urticaria, profuse nasal discharge.
7. Local reactions: swelling and soreness at the injection site.
8. Failures in the thermoregulation system: hypothermia.

Overdose

In case of an overdose, the following symptoms may occur: blanching of the skin and mucous membranes, heavy cold sweat, dizziness, nausea, vomiting, excitation or inhibition of the central nervous system, blurred vision, tremor, convulsions, respiratory depression, slowing and weakening of the pulse, loss of consciousness, fainting, collapse.

Help in case of overdose is to maintain ventilation, detoxification and symptomatic treatment.

special instructions

It is used with caution in the treatment of the elderly, seriously ill and debilitated patients.

Before treatment, a drug tolerance test is performed.

The toxicity of Novocain increases as the concentration increases.

During pregnancy and lactation

Application in childhood

For children, the drug is prescribed for health reasons with extreme caution and with strict adherence to the dosage.

drug interaction

The drug has the ability to increase the depression of the central nervous system when taken together with general anesthetics, narcotic analgesics, hypnotics, sedatives and tranquilizers.

When Novocain is combined with narcotic analgesics, an additive effect is observed and respiratory depression occurs.

Vascular preparations with vasoconstrictor action (Epinephrine, Methoxamine, Phenylephrine) increase the duration of the local anesthetic action of Novocaine.

Combined use with Suxamethonium allows you to increase the duration of the neuromuscular blockade.

The drug enhances and prolongs the effect of muscle relaxants.

The drug weakens the antimyasthenic effect of other drugs.

When taken simultaneously with anticoagulants, the risk of bleeding increases.

The combination of procaine with MAO inhibitors is fraught with the development of arterial hypotension.

Para-aminobenzoic acid, which is a metabolic product of Novocaine, can reduce the antibacterial effect of sulfonamides.

Do not treat the Novocain injection site with disinfectant solutions containing heavy metals, as this can increase swelling and pain.

Analogues

Among the analogues are:

• Novocain-Bufus;
• Novocain-Vial;
• Novocaine hydrochloride;
• Procaine;
• procaine hydrochloride;
• Benzocaine.

Terms and conditions of storage

Store in a place protected from light and out of the reach of children, at a temperature not exceeding 25ºС.

How to store and expiration date

The shelf life of the drug is 3 years.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

What is the price

The cost of Novocain hydrochloride is from 22 rubles.

How to do injections in the buttock

Basic pharmacology of local anesthetics

local anesthetic

Active substance

Procaine (procaine)

Release form, composition and packaging

Solution for injection 0.5% transparent, colorless.

Excipients: hydrochloric acid 0.1M, water for injection.

2 ml - ampoules (10) / complete with an ampoule knife or a scarifier, if necessary for ampoules of this type /) - packs of cardboard.
5 ml - ampoules (10) / complete with an ampoule knife or a scarifier, if necessary for ampoules of this type /) - packs of cardboard.
10 ml - ampoules (10) / complete with an ampoule knife or a scarifier, if necessary for ampoules of this type /) - packs of cardboard.

pharmachologic effect

A local anesthetic with moderate anesthetic activity and a wide range of therapeutic effects. Being a weak base, it blocks Na + - channels, prevents the generation of impulses at the endings of sensory nerves and the conduction of impulses along nerve fibers. Changes the action potential in the membranes of nerve cells without a pronounced effect on the resting potential. Suppresses the conduction of not only pain, but also impulses of a different modality. With absorption and direct vascular injection into the bloodstream, it reduces the excitability of peripheral cholinergic systems, reduces the formation and release of acetylcholine from preganglionic endings (it has some ganglion-blocking effect), eliminates spasm of smooth muscles, and reduces the excitability of the myocardium and motor areas of the cerebral cortex. Eliminates the descending inhibitory influences of the reticular formation of the brain stem. Inhibits polysynaptic reflexes. In high doses, it can cause convulsions. It has a short anesthetic activity (the duration of infiltration anesthesia is 0.5-1 h).

Pharmacokinetics

Undergoes complete systemic absorption. The degree of absorption depends on the site and route of administration (especially on vascularization and blood flow rate of administration) and the final dose (amount and concentration). It is rapidly hydrolyzed by esterases and the liver with the formation of two main pharmacologically active metabolites: diethylaminoethanol (has a moderate vasodilating effect) and para-aminobenzoic acid (it is a competitive antagonist of sulfanilamide drugs and can weaken their effect). T 1/2 - 30-50 s, in the neonatal period - 54-114 s. It is excreted mainly by the kidneys in the form of metabolites, no more than 2% is excreted unchanged.

Indications

Infiltration (including intraosseous) anesthesia; vagosympathetic cervical, pararenal, circular and paravertebral blockades.

Contraindications

Hypersensitivity (including to para-aminobenzoic acid and other local anesthetic esters). Children's age up to 12 years.

For anesthesia by the method of creeping infiltrate - pronounced fibrous changes in the tissues.

Carefully. Emergency operations accompanied by acute blood loss; conditions accompanied by a decrease in hepatic blood flow (for example, chronic insufficiency, liver disease); progression of cardiovascular insufficiency (usually due to the development of heart blocks and shock); inflammatory diseases or infection of the injection site; pseudocholinesterase deficiency; ; children's age from 12 to 18 years, old age (over 65 years); with caution in seriously ill and / or debilitated patients; during pregnancy and during childbirth.

Dosage

Only for procaine solution 5 mg/ml (0.5%).

For infiltration anesthesia 350-600 mg (70-120 ml) are administered. Higher doses for infiltration anesthesia for adults: the first single dose at the beginning of the operation - not more than 0.75 g (150 ml), then during each hour of the operation - not more than 2 g (400 ml) of the solution.

At pararenal blockade(according to A.V. Vishnevsky) 50-80 ml is injected into the perirenal tissue.

At circular and paravertebral blockade intradermally injected 5-10 ml. With vagosympathetic blockade, 30-40 ml is administered.

For reduce absorption and prolong action with local anesthesia, additionally injected 0.1% solution of epinephrine hydrochloride - 1 drop per 2-5-10 ml of procaine solution.

The maximum dose for use in children over 12 years old- 15 mg/kg.

Side effects

From the side of the central and peripheral nervous system: headache, dizziness, drowsiness, weakness, lockjaw.

From the side of the cardiovascular system: increase or decrease in blood pressure, peripheral vasodilation, collapse, bradycardia, arrhythmias,.

From the side of the hematopoietic organs: methemoglobinemia.

Allergic reactions: skin itching, skin rash, other anaphylactic reactions (including anaphylactic shock), urticaria (on the skin and mucous membranes). If during the use of the drug any of the side effects indicated in the instructions appear or they are aggravated, or you notice any other side effects not indicated in the instructions, tell your doctor about it.

Overdose

Symptoms: pallor of the skin and mucous membranes, dizziness, nausea, vomiting, "cold" sweat, increased respiration, tachycardia, lowering blood pressure, up to collapse, apnea, methemoglobinemia. The action on the central nervous system is manifested by a feeling of fear, hallucinations, convulsions, motor excitation.

Treatment: maintaining adequate pulmonary ventilation, detoxification and symptomatic therapy.

drug interaction

Enhances the inhibitory effect on the central nervous system of drugs for general anesthesia, hypnotics, sedatives, narcotic analgesics and tranquilizers.

Anticoagulants (sodium ardeparin, sodium dalteparin, sodium danaparoid, sodium heparin, warfarin) increase the risk of bleeding. When treating the injection site with disinfectant solutions containing heavy metals, the risk of developing a local reaction in the form of pain and swelling increases.

Use with monoamine oxidase inhibitors (, procarbazine, selegiline) increases the risk of developing a pronounced decrease in blood pressure. Enhances and prolongs the action of muscle relaxant drugs. Vasoconstrictors (epinephrine, methoxamine, phenylephrine) prolong the local anesthetic effect.

Procaine reduces the antimyasthenic effect of drugs, especially when used in high doses, which requires additional correction in the treatment of myasthenia gravis.

Cholinesterase inhibitors (antimiasthenic drugs, cyclophosphamide, demecarium bromide, ecothiopa iodide, thiotepa) reduce the metabolism of local anesthetic drugs.

The metabolite of procaine (para-aminobenzoic acid) is a sulfonamide antagonist.

special instructions

Patients require monitoring of the functions of the cardiovascular system, the respiratory system and the central nervous system.

It is necessary to cancel monoamine oxidase inhibitors 10 days before the introduction of a local anesthetic.

It should be borne in mind that when performing local anesthesia using the same total dose, the toxicity of procaine is the higher, the more concentrated the solution is used.

Influence on the ability to drive vehicles and mechanisms

During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

Pregnancy and lactation

If it is necessary to prescribe the drug during pregnancy, the expected benefit to the mother and the potential risk to the fetus should be compared. With caution during childbirth.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

Store the drug in a place protected from light, at a temperature not exceeding 25°C. Keep out of the reach of children.

Shelf life - 3 years. Do not use after the expiry date stated on the packaging.