Pharma Grade Topical Local Anesthetic Chloroprocaine Hydrochloride For Relieve Pain

Local Anesthetic Drugs Chloroprocaine Hydrochloride To Relieve Pain

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Definition

The monohydrochloride salt of chloroprocaine. Used as a local anaesthetic, particularly for oral surgery, it has the advantage over lidocaine of constricting blood vessels, so reducing bleeding.

DESCRIPTION

Short-acting ester-type local anesthetic; not effective as a topical anesthetic.

COMMON BRAND NAMES

Nesacaine, Nesacaine MPF

HOW SUPPLIED

Nesacaine MPF Epidural Inj Sol: 2%, 3%

Nesacaine MPF Intracaudal Inj Sol: 2%, 3%

Nesacaine/Nesacaine MPF Infiltration Inj Sol: 1%, 2%, 3%

DOSAGE & INDICATIONS

For regional anesthesia.

NOTE: Doses listed below are those considered necessary to produce a successful block and should be regarded as guidelines. Individual variations in onset and duration may occur.

For caudal anesthesia.

Epidural dosage

Adults

15 to 25 mL of a 2% or 3% solution (300 to 750 mg) initially, follow-up doses may be given in 40 to 60 minutes.

For epidural anesthesia.

Epidural dosage for the cervical or thoracic region

Adults

1.5 to 2 mL of a 2% or 3% solution (30 to 60 mg) for each segment to be anesthetized.

Epidural dosage for the lumbar and sacral region

Adults

2 to 2.5 mL of a 2% or 3% solution for each segment to be anesthetized.

For local anesthesia via infiltration anesthesia or nerve block anesthesia.

NOTE: Doses listed below are those considered necessary to produce a successful block and should be regarded as guidelines. Individual variations in onset and duration may occur.

Brachial plexus block.

Regional dosage

Adults

30 to 40 mL of a 2% solution (600 to 800 mg).

Cervical nerve block.

Regional dosage

Adults

3 to 4 mL of a 1% to 2% solution (30 to 80 mg) per segment.

Occipital nerve block.

Regional dosage

Adults

3 to 5 mL of a 1% to 2% solution (30 to 100 mg).

Mandibular nerve block or maxillary nerve block for dental anesthesia.

Regional dosage

Adults

2 to 3 mL of a 2% solution (40 to 60 mg).

Ophthalmic anesthesia via infraorbital nerve block.

Regional dosage

Adults

0.5 to 1 mL of a 2% solution (10 to 20 mg).

Ulnar nerve block or paravertebral block.

Regional dosage

Adults

3 to 5 mL of a 2% solution (60 to 100 mg).

Intercostal nerve block.

Regional dosage

Adults

3 mL of a 1% to 2% solution (30 to 60 mg).

Sciatic nerve block.

Regional dosage

Adults

10 to 15 mL of a 2% solution (200 to 300 mg).

Stellate ganglion block.

Regional dosage

Adults

5 to 10 mL of a 1% to 2% solution (50 to 200 mg).

Lumbar sympathetic block.

Regional dosage

Adults

15 to 20 mL of a 1% to 2% solution (150 to 400 mg).

Interdigital block.

Regional dosage

Adults

3 to 4 mL of a 1% to 2% solution without epinephrine (30 to 80 mg).

For use in obstetric anesthesia.

Pudendal nerve block.

Regional dosage

Adults

10 mL of a 2% solution (200 mg) for each side.

Paracervical block.

Regional dosage

Adults

3 mL of a 1% solution (30 mg) for each of 4 sites up to 120 mg.

MAXIMUM DOSAGE

The dose of local anesthetics differs with the anesthetic procedure; the area to be anesthetized; the vascularity of the tissues; the number of neuronal segments to be blocked; the intensity of the block; the degree of muscle relaxation required; the duration of anesthesia desired; individual tolerance; and the physical condition of the patient.

Adults

11 mg/kg, not to exceed 800 mg/dose when given without epinephrine. With epinephrine (1:200,000), 14 mg/kg, not to exceed 1000 mg.

Children

>= 4 years: 11 mg/kg. Concentrations of 0.5%-1% are suggested for infiltration, and 1%-1.5% are recommended for nerve block.

<= 3 years: Safety and efficacy have not been established.

DOSING CONSIDERATIONS

Hepatic Impairment

Specific guidelines for dosage adjustments in hepatic impairment are not available; it appears that no dosage adjustments are needed.

Renal Impairment

Specific guidelines for dosage adjustments in renal impairment are not available; it appears that no dosage adjustments are needed.

ADMINISTRATION

Injectable Administration

Visually inspect parenteral products for particulate matter and discoloration prior to administration whenever solution and container permit.

Specialized references should be consulted for specific procedures and administration techniques.

Resuscitative equipment and drugs used in the management of adverse reactions should be immediately available while administering local anesthetics.

Chloroprocaine is administered by infiltration or peripheral or sympathetic block techniques.

Other Injectable Administration

Peripheral or sympathetic block:

A solution containing 1:200,000 epinephrine/chloroprocaine hydrochloride may be prepared by adding 0.15 mL of 1:1000 epinephrine HCl injection to 30 mL of a 2 or 3% chloroprocaine HCl injection that does not contain preservatives. Do not use solutions containing epinephrine for interdigital anesthesia.
Inject slowly and with frequent aspirations to prevent intravascular injection.

Epidural Administration

This route of administration should only be used by specially trained healthcare professionals. Specialized references should be consulted for specific procedures and administration techniques.

Resuscitative equipment and drugs used in the management of adverse reactions should be immediately available while administering local anesthetics.

May be given as intermittent epidural or caudal injection, continuous epidural infusion or as patient controlled epidural analgesia.

Placement of epidural catheter and administration should be at a site near the dermatomes covering the field of pain to decrease dose requirements and increase specificity.

A test dose of 3 mL of a 3% injection or 5 mL of a 2% injection should be administered 5 minutes before administering the total dose. If the patient is moved in such a way as to displace the catheter, the test dose should be repeated. Inadvertent subarachnoid injection is indicated by motor paralysis and extensive sensory anesthesia.

Epidural or caudal block:

Injections containing preservatives should not be used for epidural or caudal block. Discard any partially used injections that do not contain preservatives.

Large single doses should be divided into fractional doses and injected slowly with frequent aspirations. Care should be taken to prevent intravascular or subarachnoid injection.

Epidural infusion:

A controlled-infusion device must be used. For highly concentrated injections, an implantable controlled-microinfusion device is used. Patients should be monitored for several days following implantation of the device.

Injections containing preservatives should not be used for epidural infusion. Discard any partially used injections that do not contain preservatives.

Preservative-free 0.9% Sodium Chloride injection is recommended for dilution.

Implantable infusion device: Filling of the infusion device reservoir should only be done by fully trained and qualified healthcare professionals. Strict aseptic technique must be used. Withdraw dose from the ampule through a 5-micrometer (or smaller pore diameter) microfilter to avoid contamination with glass or other particles. Then remove filter needle and replace with a clean needle prior to injecting the reservoir. Ensure proper placement of the needle when filling the reservoir to avoid accidental overdosage.

To avoid exacerbation of severe pain and/or reflux of CSF into the reservoir, depletion of the reservoir should be avoided.

STORAGE

Nesacaine:

- Discard product if it contains particulate matter, is cloudy, or discolored
- Protect from freezing
- Protect from light
- Store at controlled room temperature (between 68 and 77 degrees F)

Nesacaine MPF:

- Discard product if it contains particulate matter, is cloudy, or discolored
- Protect from freezing
- Protect from light
- Store at controlled room temperature (between 68 and 77 degrees F)

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