NOVOKAIN (Novocainum). b-Dietilaminoetilovogo parameters benzaminic acid ester hydrochloride.

     Synonyms : Aethocain, Allocaine, Ambocain, Aminocaine, Anesthocaine, Atoxicain, Cerocain, Chemocain, Citocain, Ethocaine, Genocaine, Herocaine, Isocain, Jenacain, Marecaine, Minocain, Naucain, Neocaine, Pancain, Paracaine, Planocaine, Polocainum, Procaine, Procaini hydrochloridum , Procaine hydrochloride, Protocaine, Sevicaine, Syncaine, Syntocain, Topocaine and others.

     Clear crystals or a white crystalline powder and odourless. Very easily soluble in water (1:1), easily soluble in alcohol (1:8). Aqueous solutions are sterilized at 100 + C for 30 min. Solutions novocaine easily gidrolizuyutsya in alkaline environment. To stabilize adds 0,1 said. hydrochloric acid solution to pH 3, 8, 4, 5.

     Novocaine was synthesized in 1905 a long time, he was the main local anestetikom applied in surgical practice. Compared with today's local anesthetics (lidocaine, bupivacaine, etc.) he has less strong anaesthetic activity. However, the relatively low toxicity, high therapeutic value breadth and additional pharmacological properties that enable its use in various areas of medicine, he still has broad application.

     Unlike cocaine addiction novocaine phenomenon is.

     In addition mestnoanesteziruyuschego action novocaine in intake and immediate implementation of current blood has a general effect on the organism : acetylcholine reduces anxiety and lowers peripheral holinoreaktivnyh systems, providing blocking effect on vegetative nerve, reduces cramps smooth muscles, reduces anxiety and heart muscle motor cortex area of brain.

     Inside the novocaine hydrolyses relatively quickly, forming acid and paraaminobenzoynuyu dietilaminoetanol.

     Products of novocaine - pharmacologically active substances. parameters Aminobenzoynaya acid (vitamin H 1) is an integral part of folic acid molecule; it is also related to the status of the other compounds found in plant and animal tissues. For bacteria parameters aminobenzoynaya acid is a "growth factor". On chemical structure similar to the part it sulfanilamidov molecule; Enter the latest in a competitive relationship, para aminobenzoynaya acid weakens their antibacterial action (see Sulfanilamidnye drugs). Novocaine as prod water parameters benzaminic acid also has antisulfanilamidnoe effect. Dietilaminoetanol has moderate sosudorasshiryayuschimi properties.

     Novocaine widely used for local anesthesia, mainly for irrigated; For surface anesthesia was little suitable as slowly permeates through intact mucous membranes. Widely designate novocaine and therapeutic blockade.

     For irrigated anestezin using 0.25 - 0.5% solutions; For anesthesia method AV Vishnevskaya (SB creeping infiltration) 0,125 - 0.25% solutions; For conductive anesthesia-1 - 2% solutions; For epidural 2% solution (20 ml - 25).

     Sometimes novocaine nominated for vnutrikostnoy anesthesia.

     For anesthesia mucous membranes novocaine sometimes used in ORL. For surface anaesthetic effect required 10-20% solution.

     With local anesthesia concentration solutions of novocaine and they depend on the nature of the intervention; The application, and the age of the patient, etc.

     It should be borne in mind that when the same total dose of drug toxicity is all the more concentrated solution is applied.

     To reduce the intake of fluids and elongation novocaine with local anesthesia usually adds to the solution via hydrochloride (0.1%) and 1 drop to 2 - 5 - 10 ml novocaine as novocaine, unlike cocaine receptacles is narrowing.

     Novocaine is also recommended for the treatment of various diseases. Novokainovaya blockade is intended to reduce reflex reaction arising from the development of pathological processes. In paranefralnoy blockade (on AV Vishnevskaya) in okolopochechnuyu fibre impose 50-80 ml of 0.5% solution or 100-150 ml of 0.25% solution of novocaine, in the vagosimpaticheskoy blockade-30-100 ml 0.25% solution.

     Solutions novocaine also used intravenously, and the interior (with hypertension, late toxicosis pregnant with PNDS syndrome, vascular spasm, phantom pain, stomach ulcers and gastrointestinal cancers, non-ulcerative colitis, ulcers, neyrodermite, eczema, keratite, iridotsiklite, glaucoma, etc. .) . In veins entering from 1 to 10 - 15 ml of 0.25 - 0.5% solution. Enter slowly better in isotonic sodium chloride solution. Injections (sometimes up to 10-20) depending on the severity of the illness and treatment.

     To remove the peripheral blood vessels and improve microcirculation in otmorozheniyah (in doreaktivnom period) offered a mixture of 10 ml of 0.25% solution of novocaine, 2 mL of 2% solution papaverina, 2 ml of 1% solution of nicotinic acid and 10,000 ED unchanged. Enter vnutriarterialno.

     Intravenous a small amount of novocaine potentsiruet funds used for narcosis, and protivoshokovoe has analgesic effects, and therefore it is sometimes used to prepare for narcosis during narcosis (to enhance the action of anaesthetics), and aftercare period (relieving pain and cramps).

     Inside are 0.25 - 0.5% solution to the 30-50 ml of 2 - 3 times a day.

     Subcutaneous injections 0,25 - 0,5% solution is recommended for circular and paravertebralnoy blockade with eczema, neyrodermite, ishiase and others.

     Candles (rektalnye) with novocaine used as a means mestnoanesteziruyuschee and skin smooth muscles in spasm intestines.

     Novocaine (5 - 10% solution) is also employed, using electrophoresis method.

     Due to the ability of the drug to reduce the excitability of cardiac muscle, he was appointed sometimes mertsatelnoy keep introducing non - 0.25% solution of 5 ml of 2-to 4 - 5 times. More effective and specific means of complications are local anaesthetics lidocaine and trimekain and derivative novocaine - novokainamid (see).

     Novocaine apply for dissolution of penicillin to lengthen its duration (see Drugs group penicillin).

     Novocaine also appointed as intramuscular injection in certain diseases bowl found in old age (endarteriit, atherosclerosis, hypertension, coronary vascular spasm and cerebral vascular diseases rheumatic joints and infectious origin, etc.). Treatment in the United States. In the muscle to impose 2% solution of 5 ml of novocaine three times a week; In the course of 12 injections, and then make a 10-day break. In the year before treatment repeat 4 times. The effect is mostly in the early stages of diseases associated with functional impairment of CNS.

     Novocaine is usually well tolerated, but can cause side effects, and all the ways it would be applied with caution. For some patients, there is increased sensitivity to drugs (dizziness, weakness, lowering AD, collapse, shock). There may develop allergic skin reaction (dermatitis, husking, etc.). To identify high sensitivity initially appointed novocaine in small doses. Intramuscularly enter first 2 ml solution of 2%, 3 days in the absence of side effects-3 ml of this solution and then proceed to a full dose of 5 ml per injection.

     The highest dose of novocaine (adult) : single when administered 0.25 g, in giving muscle (2% solution), 0.1 g (5 ml), in giving vein (0.25% solution) 0 05 g (20 mL); daily admission into 0.75 g; in introducing the muscle (2% solution) and venous (0.25% solution), 0.1 g.

     For irrigated anesthesia, the following higher doses (for adults) : First single dose at the beginning of the operation, no more than 1, 25 g 0.25% solution (that is, 500 ml) and 0.75 g 0.5% solution (t . a 150 ml). In the future, for each hour operation is not over 2, 5% solution of 0.25 g (ie 1000 mL) and 2 g of 0.5% solution (that is, 400 ml).

     Method of issuance : powder; 0.25% and 0.5% in injectable solutions to 1; 2; 5; 10 and 20 ml and 1% and 2% solution of 1; 2; 5 and 10 ml; 0.25% and 0.5% sterile solutions novocaine in bottles of 200 ml and 400; 5% and 10% ointment; candles containing 0.1 grams of novocaine.

     Novocaine is part of the integrated product "Menovazin (see).

     Storage : List B. The well ukuporennyh banks orange glass; Ampoules and candles in the dark spot.

     Rp :. Sol. Novocaini 0.25% 200 ml

     D.S. For irrigated anaesthesia

     Rp. : Sol. Novocaini 1 ml 10%

     D.t.d. N. 5 in ampull.

     S. For conductive anesthesia

     Rp. : Novocaini 1, 1925

     Natrii chloridi 3 0

     Kalii chloridi 0,038

     Calcii chloridi 0,062

     Aq. pro inject. 500 ml

     M. Steril. !

     D.S. For anesthesia method AV Vishnevskogo

     Rp. : Novocaini 0.5

     Aq. destill. 200 ml

     M.D.S. Nutr B-1 dining spoon

     Rp. : Sol. Novocaini 2% 5 ml

     D.t.d. N. in ampull 6.

     S. He is 5 ml of muscles 1 every 2 days

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