Procaine base, also known as procaine, is widely used in clinical practice as a local anesthetic, but there are some contraindications in its use. The following is a detailed summary of the contraindications in the use of procaine base:
First, the taboo of specific groups
1. Allergy: Patients who are allergic to procaine should be prohibited, because all local anesthetics have a certain allergy rate, and the occurrence of procaine allergy is relatively large. Skin test should be done before use, and positive patients should not use.
2. Patients with cardiac and renal insufficiency: Because procaine may be metabolized through the liver and kidney, the use of procaine in patients with cardiac and renal insufficiency may increase the risk of drug accumulation, so it should be used with caution or prohibited.
3. Patients with myasthenia gravis: Procaine may affect neuromuscular conduction and aggravate myasthenia gravis symptoms, so it is prohibited.
4. Pregnant and lactating women: In order to avoid adverse effects on the fetus or baby, pregnant and lactating women should avoid using procaine.
Second, drug interaction contraindications
1. Sulfonamides: Procaine can be metabolized into p-aminobenzoic acid (PABA) in the body, which can counter the antibacterial effect of sulfonamides, so it should be avoided when used with sulfonamides.
2. Para-aminobenzoic acid, physostigmine and other drugs: Procaine should be avoided at the same time with these drugs to avoid drug interactions and increase adverse reactions.
Third, the use of state taboo
1. Malnutrition and hunger: the use of procaine in these states is prone to toxic reactions, so pay attention to reducing the amount of medication.
2. High concentration or rapid injection into blood vessels: When procaine dose is too large or rapid injection into blood vessels, it can cause nausea, sweating, rapid pulse, dyspnea and other adverse reactions, until coma and respiratory paralysis. Therefore, the dosage and injection speed should be strictly controlled when used.
Fourth, other precautions
1. It should not be compatible with glucose solution: it can reduce its local anesthesia effect.
2. Preparation before anesthesia: During lumbar anesthesia, blood pressure often drops, which can be prevented by intramuscular injection of ephedrine before anesthesia.
3. Monitoring adverse reactions: Patients' reactions should be closely observed during the medication process, and if they feel unwell, they should contact the doctor in time.
To sum up, the contraindications of procaine base involve many aspects, such as specific population, drug interaction and use state. When using procaine, be sure to strictly follow the doctor's instructions and drug instructions to ensure that the drug is safe and effective.