ACKNOWLEDGMENT

Procaine Hydrochloride
-also called Novocain or Novocaine

-synthetic organic compound

-used in medicine as a local anesthetic

-amino ester group

-introduced in 1905 under the trade name Novocaine

-first & best-known substitute for cocaine in local anesthesia

-unlike cocaine, it is not:
~toxic

~addicting

~irritating

-first injectable man-made local anesthetic

-created by Germany chemist Alfred Einhorn (1857-1917)
~gave the chemical trade name

~from Latin:
:Novus (meaning New)
:caine (common ending for alkaloids used as anesthetics)

-introduced into madical use by surgeon Heinrich Braun (1862-1934)

-excreted by the kidneys into the urine



-allergic reactions to procaine are usually not in response to procaine itself, but to PABA (para-amino benzoid acid)

-procaine is the primary ingredient in the controversial preparation Gerovital H3 (GH3)



-administered by injection (I.M.)

Functions
-dental anesthesia / dentistry

-nerve-block (constricting blood vessels: reduces bleeding)

-spinal



-caudal anesthesia

-reduce the pain of injection of penicillin

-improves cell metabolism



-improves concentration

-improves memory

-well-being

-improves skin complexion

-improve hair condition



-blocks the generation & construction of nerve impulse by decreasing the permeability of the nerve membrane to ions: loss of nerve function occurs:
~loss of autonomic activity

~loss of pain sensation

~loss of sensory function

~loss of motor activity

-control of premature aging

Appearance
-colorless / white odourless crystals

-white crystalline powder

-soluble in water, alcohol & slightly soluble in chloroform

-the injection:
~clear

~colorless to pale yellow

~sterile solution of procaine hydrochloride

Use in Pregnancy

It is known that Procaine hydrochloride crosses the placenta. However, limited studies on pregnant women have shown that the frequencies of malformations and congenital anomalies were not increased among the children of women who had been treated with procaine during the pregnancy. Please see below for use of Procaine during labour.

Labour: Paracervical or pudendal anaesthesia may produce changes in uterine contractility and/or maternal expulsive efforts. Maternal hypotension may occur during regional anaesthesia. Administration of local anaesthetics by paracervical nerve block during labour has been associated with a high incidence of foetal acidosis and bradycardia and has occasionally resulted in perinatal death. The risk of foetal bradycardia appears to be increased with prematurity, toxaemia of pregnancy, and foetal distress. Possible inadvertent foetal intracranial injection has reportedly occurred following attempted paracervical and/or pudendal block. This results in unexplained neonatal depression at birth, associated with high serum concentration of local anaesthetic, and seizures usually occurring within 6 hours. Prompt use of supportive measures and forced urinary excretion of the local anaesthetic has reportedly been effective for managing this complication.

Use in Lactation

It is not known whether procaine hydrochloride is distributed into breast milk. Problems in humans have not been documented, but due to lack of data the use of procaine hydrochloride is not recommended in lactating patients.

Hypersensitivity Reactions

Hypersensitivity or allergic reactions due to use of procaine are rare. These reactions may be characterised by urticaria, skin rash, redness and hives.

More serious allergic reactions include pruritus (the symptom of itching, an uncomfortable sensation leading to the urge to scratch which often results in secondary infection), angioedema (an acute painless, dermal, subcutaneous or submucosal swelling of short duration involving the face, neck, lips, larynx, hands feet, genitalia, or viscera) and anaphylaxis (an exaggerated, life-threatening hypersensitivity reaction which may be a localised wheal and flare of generalised itching, hyperaemia, angioedema, and in severe cases vascular collapse, asthma and bronchitis, and shock).

It should be noted that although skin testing in patients with suspected drug sensitivity has been recommended, the usefulness of screening for sensitivity is at present controversial. Moreover, the testing itself can cause severe or anaphylactic reactions.

Other reactions

The following reactions may also occur: transient burning at the injection site, skin discolouration, tissue irritation, neurolysis, neuritis, tissue necrosis, prolonged burning pain and sloughing.