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Aug.2024 23
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What are the adverse reactions and precautions of procaine?

Introduction
Procaine, as a local anesthetic, has a wide range of application value, but there are some adverse reactions and matters needing attention. The following is a detailed summary of the adverse reactions and precautions of procaine:
Details

Procaine, as a local anesthetic, has a wide range of application value, but there are some adverse reactions and matters needing attention. The following is a detailed summary of the adverse reactions and precautions of procaine:

Adverse reaction

1. Nervous system reaction:

- Procaine can produce toxic reactions when given in excess doses per unit time or when accidentally intravascular administration occurs. Toxicity can be divided into excitatory type and inhibitory type. The excitatory type is characterized by nervousness, hyperactivity, a mild increase in heart rate, and in severe cases, shortness of breath, irritability, elevated blood pressure, cyanosis, and even muscle tremors or convulsions, which may eventually lead to respiratory depression and cardiac arrest. The inhibitory type is characterized by apathy, lethargy or loss of consciousness, and in severe cases, shallow slow breathing, intermittent breathing, slow pulse, and falling blood pressure may also lead to cardiac arrest. 

- Occasional reports of reactive psychosis. 

2. Allergic reactions:

- Procaine may cause allergic reactions, including erythema, pruritus, rash, urticaria, edema, etc. In severe cases, it may lead to cardiovascular shock or collapse. 

- Occasionally hypersensitivity and atopy. 

3. Cardiovascular system reaction:

- Procaine has an inhibitory effect on the cardiovascular system, which can weaken the myocardial contractile force, slow the heart rate, drop blood pressure, and even lead to conduction block, arrhythmia and cardiac arrest. 

4. Blood system reaction:

- Methemoglobinemia is occasionally seen and causes hypoxia. 

5. Other reactions:

- Oral reactions: Prolonged lip numbness, tremors, or swelling.

- The side effects of compound procaine hydrochloride tablets also include nausea, dizziness, drowsiness, etc. 

Matters needing attention

1. Preparation before use:

- Need to do allergy test before use, not for those who are allergic to procaine. 

- If the patient has local skin damage, it is generally not recommended to use procaine for treatment in order to avoid infection. 

2. Dosage:

- A single dose is usually 0.5-1g for adults and 3-4mg/kg for children. Patients with serious conditions can appropriately increase the dosage, but must strictly follow the doctor's advice to avoid blind medication. 

- Pay attention to the relative and absolute dose of procaine to avoid adverse reactions caused by excessive use. 

3. Injection site:

- When injecting procaine, pay attention to the injection position and avoid injecting into the blood vessel, otherwise it may cause local pain or other uncomfortable symptoms. 

4. Special people should not use:

- Procaine is contraindicated in patients with digital and digital block anesthesia and hypertension. 

- Pregnant and lactating women, patients with severe heart disease, hypertension, and hyperthyroidism should be used with caution. 

5. Drug interactions:

Procaine may have adverse interactions with certain drugs, such as cycloamines, p-aminobenzoic acid, physostigmine, etc. Care should be taken to avoid taking these drugs with procaine. 

6. Observation and monitoring:

- During the use of procaine, the patient's reaction should be closely observed, and once discomfort occurs, the doctor should be informed immediately and treated in time. 

In summary, procaine should be used in strict compliance with medical instructions and operating procedures, and attention should be paid to the dosage, injection site and contraindications and careful use of special populations. Meanwhile, patients' reactions should be closely monitored to prevent adverse reactions.

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