Novocaine 2 x percentage benefit. Composition and forms of release

Instructions for use Novocain 0.5% and 2% solution for injection
as a local anesthetic for animals
(Organization-developer: CJSC Mosagrogen, Moscow region, Domodedovo)

I. General information
Trade name of the drug: Novocaine 0.5% and 2% solution for injection (Novocaini 0.5%, 2% solutio pro injectionibus). International non-proprietary name: procaine.

Dosage form: solution for injections.
Novocaine 0.5% and 2% injection as an active ingredient in 100 ml contains, respectively, 0.5 g or 2.0 g of procaine hydrochloride, and as an auxiliary substance, water for injection up to 100 ml.
In appearance, the drug is a clear, colorless liquid.

Novocain 0.5% and 2% solution for injection is produced packaged in 20 ml and 100 ml in glass bottles of the appropriate capacity, sealed with rubber stoppers, reinforced with aluminum caps. Vials of 20 ml are placed in 40 pieces in cardboard boxes along with instructions for use.

Store the drug in the manufacturer's closed packaging, in a dry place, protected from direct sunlight, away from food and feed, at a temperature of 0°C to 25°C.
The shelf life of the medicinal product, subject to storage conditions, is 3 years from the date of manufacture. It is forbidden to use Novocain 0.5% and 2% solution for injection after the expiration date. It should be stored out of the reach of children.
The unused drug is disposed of in accordance with the requirements of the law.

II. Pharmacological properties
Novocain belongs to the group of local anesthetic drugs.
Novocaine blocks sodium channels, displaces calcium from receptors located on the inner surface of the membrane and, thus, prevents the generation of impulses at the endings of sensory nerves and the conduction of impulses along nerve fibers. Suppresses the conduction of not only pain, but also impulses of a different modality. When administered intravenously, it has a general effect on the body of animals, reduces the formation of acetylcholine and lowers the excitability of peripheral choline-reactive systems, has a blocking effect on autonomic ganglia, reduces spasms of smooth muscles, reduces the excitability of the heart muscle and the excitability of the motor areas of the cerebral cortex. In toxic doses causes excitation, then paralysis of the central nervous system.
It is rapidly hydrolyzed in the body, forming para-aminobenzoic acid and diethylaminoethanol, which are pharmacologically active substances.
After administration, the drug acts quickly and briefly.

According to the degree of impact on the body, Novocaine 0.5% and 2% injection solution belongs to low-hazard substances (hazard class 4), novocaine powder - to highly hazardous substances (hazard class 2) according to GOST 12.1.007-76.

III. Application procedure
Novocaine 0.5% and 2% solution for injection is used, if necessary, after diluting with sterile saline to the desired concentration, for infiltration anesthesia in the form of a 0.25% -0.5% solution; for anesthesia according to the method of A.V. Vishnevsky (tight creeping infiltration) - 0.125% -0.25%; for conduction and spinal anesthesia 1% -2%.
In ophthalmology, a 0.5% solution of novocaine is used for keratitis, keratoconjunctivitis, periodic inflammation of the eyes in horses (infraorbital blockade).
In obstetric and gynecological practice, novocaine solutions are prescribed for endometritis, metritis, prolapse of the uterus and vagina, retention of the placenta in cows and goats (perinephric blockade according to A.V. Vishnevsky), with serous-catarrhal mastitis (blockade of the udder nerves according to B.A. Bashkirov or D.D. Logvinov) in the form of a 0.25% -0.5% solution.
Novocain 0.5% and 2% injection is also used as a solvent for drugs.

Contraindications to the use of Novocaine 0.5% and 2% solution for injection have not been established, with the exception of individual hypersensitivity to procaine.

Novocaine solutions are used subcutaneously, intramuscularly.

The concentration of the solution, dose, method of application depend on the nature of the surgical intervention or the course of the disease, the type, weight, age of the animal and its condition.

When conducting local anesthesia, the toxicity of novocaine is the higher, the more concentrated the solution used is. In this regard, with an increase in the concentration of the solution, the total dose is reduced or the standard solution of the drug is diluted to a lower concentration (0.125% -0.25%) with a sterile isotonic solution of sodium chloride 0.9% or Ringer-Locke solution. These dilutions are prepared
immediately before use.

Maximum doses of novocaine in ml per animal:

Re-introduction of novocaine solutions is carried out according to indications, but not earlier than 24 hours after the first injection.

In case of an overdose, novocaine causes excitation, then paralysis of the central nervous system. In these cases, drugs are used that stimulate the work of the cardiovascular and respiratory systems, infusion solutions.

Features of the action of the drug during its first use and cancellation have not been established.
The drug is used, as a rule, once.
In recommended doses, it does not cause side effects and complications in animals.

The use of Novocain 0.5% and 2% solution for injection does not preclude the use of other drugs. Simultaneous use with sulfonamides is prohibited.

Products of animal origin obtained from animals after the use of Novocaine 0.5% and 2% solution for injection can be used without restrictions.

IV. Measures of personal prevention
When working with Novocain 0.5% and 2% solution for injection, you should follow the general rules of personal hygiene and safety precautions provided for when working with drugs.
In case of accidental contact of the drug with the skin or mucous membranes of the eye, immediately rinse them with plenty of water. People with hypersensitivity to procaine should avoid direct contact with Novocain 0.5% and 2% injection. In case of allergic reactions or in case of accidental ingestion of the drug into the human body, you should immediately contact a medical institution (you should have instructions for using the drug and a label with you).

An empty container from under the drug is forbidden to be used for domestic purposes; it must be disposed of with household waste.

Manufacturing organization CJSC Mosagrogen, Russian Federation, Moscow region, 142000, Domodedovo, Kutuzovsky pr., 10-77.
Production address: 117545, Moscow, 1st Dorozhny proezd, 1.

With the approval of this instruction, the instruction for the use of Novocaine 0.5% and 2% solution for injection, approved by the Rosselkhoznadzor on 04/24/2009, becomes invalid.

Instructions for use

Active ingredients

Release form

Compound

1 ml of drops contains 6.8 mg of timolol maleate (5 mg of timolol). Excipients: benzalkonium chloride; sodium dihydrophosphate monohydrate; disodium phosphate dodecahydrate; sodium chloride; disodium edetate dihydrate; sodium hydroxide; purified water

Pharmacological effect

Local anesthetic with moderate activity and a wide range of therapeutic effects. When administered intravenously, it exhibits analgesic and anti-shock activity, hypotensive and antiarrhythmic effects. It 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. 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, reduces spasm of smooth muscles, and inhibits 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 large doses, it can disrupt neuromuscular conduction, cause convulsions. Shows a short anesthetic activity (the duration of infiltration anesthesia is 0.5–1 h). Compared with lidocaine and buvicaine, procaine has a less pronounced anesthetic effect, and therefore, it has a relatively low toxicity and a greater therapeutic breadth. The antiarrhythmic effect is due to an increase in the refractory period, a decrease in the excitability and automatism of the myocardium. When administered intramuscularly, it is effective for the treatment of elderly patients in the early stages of diseases associated with functional disorders of the central nervous system

Pharmacokinetics

When administered parenterally, it is well absorbed. The degree of absorption depends on the site and route of administration (especially on vascularization and blood flow velocity in the injection site) and the final dose (amount and concentration). It is rapidly hydrolyzed by plasma and tissue esterases and cholinesterases to form two main pharmacologically active metabolites: diethylaminoethanol (has a moderate vasodilating effect) and para-aminobenzoic acid (it is a competitive antagonist of sulfanilamide chemotherapeutic drugs and can weaken their antimicrobial effect). The half-life is 30-50 s, in the neonatal period - 54-114 s. It is excreted mainly by the kidneys in the form of metabolites (80%); no more than 2% is displayed unchanged. Metabolism of procaine is impaired in patients with a genetic deficiency of plasma cholinesterase. Poorly absorbed through mucous membranes

Indications

Infiltration, conduction, epidural and spinal anesthesia; vagosympathetic and pararenal blockade; pain syndrome with peptic ulcer of the stomach and duodenum, hemorrhoids, nausea

Contraindications

Individual sensitivity

Precautionary measures

Before using procaine, it is mandatory to conduct a skin test for individual sensitivity to the drug, which is evidenced by swelling and redness of the injection site. When using the drug, control of the functions of the cardiovascular, respiratory and central nervous systems is required. To reduce systemic action, toxicity and prolong the effect of local anesthesia, procaine is used in combination with vasoconstrictors (0.1% solution of epinephrine hydrochloride at the rate of 1 drop for 2–5 ml of novocaine solution). When conducting local anesthesia when using the same total dose, the toxicity of procaine is the higher, the more concentrated the solution used is. In this regard, with an increase in the concentration of the solution, it is recommended to reduce the total dose or dilute the solution of the drug to a lower concentration (sterile isotonic sodium chloride solution). To prevent the development of hypersensitivity reactions, therapy begins with the introduction of 2 ml of a 2% solution, after 3 days (in the absence of side effects ) is administered 3 ml, then proceed to the introduction of a full dose - 5 ml per injection. The drug is used with caution in emergency operations accompanied by acute blood loss, conditions accompanied by a decrease in hepatic blood flow, progression of cardiovascular insufficiency (usually due to the development of heart blocks and shock) , inflammatory diseases or infection of the injection site, pseudocholinesterase deficiency, renal failure, childhood (under 18 years of age), in elderly patients (over 65 years of age), seriously ill, debilitated patients, during pregnancy, during childbirth and lactation (breastfeeding) Procaine slowly penetrates through damaged mucous membranes, as a result of which it does not provide surface anesthesia. During the period of outpatient treatment, it is necessary to refrain from driving vehicles and performing work that requires increased attention, speed of mental and motor reactions

Use during pregnancy and lactation

During pregnancy and lactation, the drug is used only if the benefit to the mother outweighs the potential risk to the fetus and child.

Dosage and administration

Novocaine is administered intramuscularly - 5-10 ml of a 1-2% solution 3 times a week for a month, after which a 10-day break is taken; for infiltration anesthesia, 0.25-0.5% solutions are used, for conduction anesthesia - 2% solution. Inside - 1/2 tsp (for pain). Method of application and dose. Novocaine is used intradermally, intramuscularly, intravenously. For infiltration anesthesia, a 0.25-0.5% solution is used, for anesthesia according to the Vishnevsky method (tight creeping infiltration) - 0.125-0.25% solutions, for conduction anesthesia - 1-2% solutions, for epi- or epidural anesthesia - 2% solution. Perhaps the appointment for intraosseous anesthesia. If it is necessary to use lower concentrations of procaine (0.125% or 0.25%), the solutions are diluted with a sterile isotonic sodium chloride solution to the required concentration before use. Intravenous administration is carried out slowly, preferably in isotonic sodium chloride solution. With local anesthesia, the dosing regimen is individual, depending on the type of anesthesia, route of administration, indications, condition and age of the patient. For conduction anesthesia, up to 25 ml of a 2% solution is injected; for epidural - 20-25 ml of 2% solution. Higher doses of procaine in conduction blockade of nerves and plexuses, epidural anesthesia - no more than 0.5 g once without epinephrine or 1 g with epinephrine. With pararenal blockade (according to Vishnevsky), 50-80 ml of a 0.5% solution are injected into the perirenal tissue, with vagosympathetic blockade - 30-100 ml of a 0.25% solution. To stop the pain syndrome, it is used intramuscularly or intravenously. Intravenously injected from 1 ml to 10-15 ml of a 0.5% solution. For circulatory and paravertebral blockade in eczema and neurodermatitis, novocaine 0.5% is used intradermally. For the treatment of early stages of diseases that are more common in the elderly (endarteritis, atherosclerosis, arterial hypertension, spasms of the coronary vessels and cerebral vessels, diseases of rheumatic and infectious origin, etc.), a 2% solution of 5 ml is administered intramuscularly 2 times a week, the course - 12 injections, break - 10 days (four courses are possible during the year). With atrial fibrillation, a 0.25% solution of 2-4 ml is administered intravenously 4-5 times a day. For adults, the maximum single dose for intramuscular injection is 0.1 g, intravenous - 0.05 g; the maximum daily dose for both routes of administration is 0.1 g. Doses for children depending on age and body weight have not been developed. Novocaine is also used to dissolve antibiotics of the penicillin group in order to lengthen their duration.

Side effects

Dizziness, weakness, hypotension, allergic reactions

Overdose

Symptoms: pallor of the skin and mucous membranes, dizziness, nausea, vomiting, increased nervous excitability, cold sweat, tachycardia, lowering blood pressure almost to collapse, tremor, convulsions, apnea, methemoglobinemia, respiratory depression, sudden cardiovascular collapse. The action on the central nervous system is manifested by a feeling of fear, hallucinations, convulsions, motor excitation. In cases of overdose, the administration of the drug should be stopped immediately. During local anesthesia, the injection site can be punctured with adrenaline. Treatment: general resuscitation measures, which include oxygen inhalation, if necessary, mechanical ventilation. If convulsions continue for more than 15-20 seconds, they are stopped by intravenous administration of thiopental (100-150 mg) or diazepam (5-20 mg). With arterial hypotension and / or myocardial depression, ephedrine (15-30 mg) is administered intravenously, in severe cases, detoxification and symptomatic therapy. In case of development of intoxication after the injection of novocaine into the muscles of the leg or arm, an urgent application of a tourniquet is recommended to reduce the subsequent entry of the drug into the general circulation

Interaction with other drugs

Prolongs the neuromuscular blockade caused by suxamethonium (since both drugs are hydrolyzed by plasma cholinesterase). The use simultaneously with MAO inhibitors (furazolidone, procarbazine, selegelin) increases the risk of arterial hypotension. The toxicity of procaine is increased by anticholinesterase drugs (suppressing its hydrolysis). The metabolite of procaine (para-aminobenzoic acid) is a competitive antagonist of sulfanilamide drugs and can weaken their antimicrobial effect. 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. Potentiates the action of direct anticoagulants. The drug reduces the effect of anticholinesterase drugs on neuromuscular transmission. Possible cross-sensitization

special instructions

With caution: in violation of the function of the cardiovascular system; with heart failure

Solutions of novocaine 0.5%, 1%, 2% - contain in their composition: β-diethylaminoethyl ester of para-aminobenzoic acid hydrochloride and water for injection. It is a colorless transparent liquid. Packed in bottles of 10, 20, 100, 200, 250, 400, 450 or 500 ml.

PHARMACOLOGICAL PROPERTIES

Novocain has a wide breadth of therapeutic action. When absorbed and directly injected into the bloodstream, it has a general effect on the body, reduces the formation of acetylcholine and lowers the excitability of peripheral cholinergic systems, has a blocking effect on autonomic ganglia, reduces spasms of smooth muscles, reduces the excitability of the heart muscle and the excitability of the motor areas of the cerebral cortex. In the body, novocaine is hydrolyzed, forming para-aminobenzoic acid and diethylaminoethanol, which are pharmacologically active substances. Para-aminobenzoic acid is an integral part of the folic acid molecule, has an antihistamine effect, participates in detoxification processes, and has an antisulfanilamide effect. Diethylaminoethanol has a moderate vasodilating effect. Resorbed novocaine, affecting interoreceptors, causes a restructuring of the autonomic innervation and thus has a long-term therapeutic effect in hypertension, a number of pulmonary and other diseases. The anesthetic property of novocaine manifests itself quickly and acts for a short time.

INDICATIONS

For local anesthesia, therapeutic blockades for various diseases, dissolution of penicillin and other drugs. For the treatment of various non-contagious diseases in combination with specific and symptomatic agents, the drug is prescribed for gastric ulcers, atony with tympania of the proventriculus and intestines, dyspepsia, spastic colic, mechanical intestinal obstruction, traumatic peritonitis, reticuloperitonitis, spasm of blood vessels (blockade according to V.V. Mosin and lumbar blockade according to A.I. Fedotov). In ophthalmology, novocaine is used for keratitis, keratoconjunctivitis, periodic inflammation of the eyes in horses (infraorbital blockade). In surgery, novocaine is used to treat wounds, ulcers, fistulas, myositis, papillomatosis (intradermal or intravenous). In obstetric and gynecological practice, novocaine is prescribed for metritis, endometritis, prolapse of the uterus and vagina, retention of the placenta in cows and goats (perinephric blockade), with serous-catarrhal mastitis (central injection into the affected lobe and by blockade of the udder according to B. A. Bashkirov or D. D. Logvinov).

DOSES AND METHOD OF APPLICATION

Novocaine is used for infiltration anesthesia in the form of 0.25 - 0.5% solutions administered in an amount of 30 - 300 ml, and in some cases - several liters; for anesthesia according to the method of A. V. Vishnevsky (tight creeping infiltration) - 0.125 - 0.25%; spinal anesthesia - 1 - 2%. For novocaine blockade of the celiac nerves and borderline sympathetic trunks (according to Mosin), a 0.5% solution of novocaine is used. The solution is injected at the point of intersection of the anterior edge of the last rib with the lateral edge of the longissimus muscle until it stops in the body of the penultimate thoracic vertebra. Cattle and horses are injected with 0.5 ml per 1 kg of body weight; pigs, sheep, goats and dogs - 15-20 ml per animal; foxes, rabbits and cats - 3 - 5 ml per animal on each side. For a short novocaine blockade of the nerves of the udder (according to Logvinov), 150-200 ml of a 0.5% solution of novocaine is injected into the suprapyatnia of the affected quarter. For blockade of the external pudendal nerve (according to Bashkirov), 80-100 ml of a 0.5% solution of novocaine is injected into the loose tissue between the large and small lumbar muscles of the corresponding side. For pararenal blockade (according to Vishnevsky), novocaine is injected into the perirenal tissue in the form of 0.25 - 0.5% solutions. Novocaine solutions are used intravenously, subcutaneously and orally (0.25 - 0.5%), intramuscularly (1 - 2%), in the aorta (1%). The concentration and dose depend on the weight, age of the animal, the course of the disease, the type of anesthesia and the nature of the surgical intervention. The maximum single dose of novocaine per head: horses 2.5 g, cattle 2 g, dogs 0.5 g or (in ml per animal).

SIDE EFFECTS

In very rare cases, allergic reactions. In toxic doses causes excitation, then paralysis of the central nervous system.

CONTRAINDICATIONS

Hypersensitivity to the drug.

SPECIAL INSTRUCTIONS

To reduce absorption and lengthen the action during local anesthesia, a solution of adrenaline hydrochloride (0.1%) is added, 1 drop per 2-10 ml of novocaine solution.

STORAGE CONDITIONS

List B. In the manufacturer's closed packaging, in a dry, protected from direct sunlight, out of the reach of children and animals, separately from food and feed at a temperature of 0 - 25 ° C. The shelf life of the drug is 3 years from the date of manufacture.

Composition and form of release

Solution - 1 ml: procaine 20 mg.

2 ml - ampoules (10) - packs of cardboard.

2 ml - ampoules (5) - blister packs (2) - cardboard packs.

Description of the dosage form

Solution for injection 0.5%.

pharmachologic effect

A local anesthetic with moderate anesthetic activity and a wide range of therapeutic effects. Being a weak base, it blocks sodium channels, displaces calcium from receptors located on the inner surface of the membrane and, thus, 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. When it enters the systemic circulation, it reduces the excitability of peripheral cholinergic systems, reduces the formation and release of acetylcholine from preganglionic endings (it has a weak ganglioblocking effect), eliminates spasm of smooth muscles, and reduces the excitability of the myocardium and motor areas of the cerebral cortex. Compared with lidocaine and bupivacaine, procaine has a less pronounced anesthetic effect and, therefore, has a relatively low toxicity and a greater therapeutic breadth.

Pharmacokinetics

Poorly absorbed through mucous membranes. When administered parenterally, it is well absorbed, rapidly hydrolyzed by plasma and tissue esterases with the formation of two main pharmacologically active metabolites: diethylaminoethanol (has a moderate vasodilating effect) and PABA. T1 / 2 - 0.7 min. It is excreted mainly by the kidneys in the form of metabolites - 80%.

Clinical pharmacology

local anesthetic.

Indications for use

Infiltration, conduction, epidural and spinal anesthesia, intraosseous anesthesia, anesthesia of the mucous membranes (in ENT practice); vagosympathetic and pararenal blockade. Circular and paravertebral blockade in eczema, neurodermatitis, ischalgia.

In / in: to potentiate the action of the main means for anesthesia; for the relief of pain syndrome of various origins.

V / m: to dissolve penicillin in order to lengthen its duration; as an adjuvant for certain diseases that are more common in old age, incl. endarteritis, atherosclerosis, arterial hypertension, spasms of the coronary vessels and brain vessels, diseases of the joints of rheumatic and infectious origin.

Rectally: hemorrhoids, intestinal smooth muscle spasms, anal fissures.

Contraindications for use

Hypersensitivity to procaine.

Use in pregnancy and children

During periods of pregnancy and lactation, Procaine should be used when the benefit outweighs the risk to the pregnant woman, fetus and newborn.

Side effects

Perhaps: arterial hypotension, collapse, dizziness, weakness, urticaria, allergic reactions, anaphylactic shock.

drug interaction

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

The procaine metabolite PABA is a competitive antagonist of sulfonamides and may weaken their antimicrobial activity.

Dosage

Individual, depending on the type of anesthesia, route of administration, indications.

Precautionary measures

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

Procaine penetrates slowly through intact mucous membranes, so it is not very effective for surface anesthesia.

As an adjuvant, procaine is used intravenously and orally for arterial hypertension, late toxicosis of pregnant women with hypertension, spasms of blood vessels, phantom pains, peptic ulcer of the stomach and duodenum, UC, itching, neurodermatitis, eczema, keratitis, iridocyclitis, glaucoma.

Novocaine

International non-proprietary name

Dosage form

Solution for injection 0.5% 2 ml, 5 ml; 2% 2 ml

Compound

1 ml of the drug contains

active substance- procaine hydrochloride 5.0 mg or 20.0 mg,

Excipients: solution of 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 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

Local anesthetic agent with moderate anesthetic activity

and a wide range of therapeutic effects. Being a weak base

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 Novocain.

Maximum doses of Novocaine(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, Novocaine 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 during spinal and epidural anesthesia, while respiratory depression is enhanced.

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

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 Novocain, 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 failure, 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

0.5% solution of 2 ml No. 5 or No. 10; 2% solution of 2 ml No. 5 or No. 10 in neutral glass ampoules for syringe filling or sterile imported ampoules for syringe filling, with a break point or a break ring.

0.5% solution of 5 ml No. 5 in neutral glass ampoules or in neutral glass ampoules for syringe filling or sterile imported ampoules for syringe filling, with a break point or a break ring.

Each ampoule is labeled with label paper or writing paper.

A 0.5% solution of 2 ml of 5 or 10 ampoules, or 5 ml of 5 ampoules is packed in a blister pack made of PVC film and aluminum or imported foil.

A 2% solution of 2 ml of 5 or 10 ampoules is packed in a blister pack made of PVC film and aluminum or imported foil.

Boundary packages, together with approved instructions for medical use in the state and Russian languages, are placed in boxes made of cardboard or corrugated cardboard. The number of instructions for medical use is nested according to the number of packages.

Storage conditionsI am

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

Keep out of the reach of children!

Termstorage

Do not use after the 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]