Uses of Chloroprocaine

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1. Uses of the drug Chloroprocaine

What is Chloroprocaine drug? Chloroprocaine, like other local anesthetics, blocks the generation and conduction of nerve impulses by slowing the propagation of nerve impulses, increasing the threshold for electrical excitation in the nerve, and decreasing the rate of increase of the action potential. In general, the progression of anesthesia is related to the diameter, myelinogenesis, and conduction velocity of the affected nerve fibers. Clinically, the order of neurologic loss is as follows: (1) pain, (2) temperature, (3) touch, (4) touch, and (5) skeletal muscle tone.
Systemic absorption of local anesthetics produces effects on the cardiovascular and central nervous systems. At blood concentrations achieved with normal therapeutic doses, changes in cardiac conduction, excitability, refractive power, peripheral vascular resistance, and contractility are minimal. However, blood levels of toxins reduce the conduction and excitability of the heart, which can lead to atrioventricular block and eventually cardiac arrest. In addition, with toxic concentrations in the blood, myocardial contractility may be impaired and peripheral vasodilation may occur, resulting in decreased cardiac output and arterial blood pressure.
After systemic absorption, toxic blood concentrations of the local anesthetic may produce central nervous system stimulation, depression, or both. Visible CNS stimulation may manifest as restlessness, tremors, and tremors, which may progress to convulsions. Depression and coma may occur, which may eventually progress to respiratory arrest.

2. Indications and contraindications of the drug Chloroprocaine

Chloroprocaine is commonly used to relieve pain during surgery with an expected duration of less than 40 minutes by spinal anesthesia or sympathetic or peripheral nerve block.
Absolutely do not use Chloroprocaine in the following cases:
Hypersensitivity to any component of the drug Chloroprocaine Severe anemia Blood infection Infection at the site of anesthesia Cardiac conduction abnormalities Do not use intravenous procaine circuit for people with myasthenia gravis.

3. Dosage and how to use Chloroprocaine

Chloroprocaine is used by qualified medical personnel, the dose is adjusted according to the individual, the area of ​​​​the area of ​​​​anesthesia, the blood vessels of the area of ​​​​anesthesia and the technique of anesthesia. The maximum recommended dose is 50mg (5ml) of Chloroprocaine hydrochloride.
Chloroprocaine is not recommended for children and adolescents.
Dosage should be reduced in patients with concomitant disorders (arteriosclerosis, diabetic polyneuropathy, vascular occlusion).
When overdosing, the first symptoms are usually paresthesia in the mouth, numbness of the tongue, dizziness, tinnitus. Visual disturbances and muscle spasms are more severe, which can lead to generalized convulsions. Severe cases can cause cardiac toxicity, hypotension, bradycardia, arrhythmia, cardiac arrest.
When this happens, it is necessary to ensure adequate oxygen supply to the patient by: keeping the airway open, giving oxygen, intubating if necessary. When there is heart failure, it is necessary to stabilize the circulation. If the convulsions do not go away, intravenous anticonvulsants can be used.
Do not use sedation in case of local anesthetic poisoning. If serious complications occur, you can seek the support of a specialist in emergency resuscitation.

4. Undesirable effects

During the use of Chloroprocaine, patients may experience the following undesirable effects:
Systemic: The most common acute adverse effects requiring immediate treatment are related to central nervous system and cardiovascular system. These side effects are usually dose related and may be due to rapid absorption from the injection site, decreased tolerability, or failure of the local anesthetic solution to enter the bloodstream. In addition to systemic dose-related toxicity, unintentional subarachnoid injection during anesthesia may result in hypoventilation or apnea. Factors that affect plasma protein binding, such as acidosis, systemic disease that alters protein synthesis, or competition with other drugs for protein binding sites, may impair protein binding. reduced patient tolerance. Lack of plasma cholinesterase may reduce tolerability to Chloroprocaine. Central nervous system reactions: characterized by excitability and/or depression. Anxiety, restlessness, ringing in the ears, dizziness, blurred vision or tremors may occur, which may lead to convulsions. However, euphoria may be transient or absent, with depression being the first manifestation of the adverse reaction, followed by somnolence accompanied by unconsciousness and respiratory arrest. The incidence of seizures associated with local anesthetic use varies with the procedure used and the total dose administered. Cardiovascular System Reactions: High doses may lead to high plasma concentrations and have been associated with myocarditis, hypotension, bradycardia, ventricular arrhythmias, and possibly cardiac arrest. Allergies: very rare and possible due to sensitivity to local anesthetics, characterized by signs such as urticaria, inflammation, itching, angioedema, erythema, tachycardia, dizziness, sneezing, nausea, vomiting, fainting, sweating, high temperature, and possibly anaphylaxis (including severe hypotension).

5. Drug interactions

The use of local anesthetics containing epinephrine or norepinephrine in patients receiving monoamine oxidase inhibitors, phenothiazines, or tricyclic antidepressants or may cause severe, prolonged blood pressure disturbances. Therefore, the simultaneous use of these preparations should be avoided. In situations where concomitant treatment is required, the patient should be carefully monitored. Concomitant use of vasopressors (for the treatment of obstetric-related hypotension) and ergot-type oxytocics may cause severe, persistent hypertension or cerebrovascular accident. The para-aminobenzoic acid metabolite of Chloroprocaine inhibits sulfonamide activity. Therefore, Chloroprocaine should not be used under any conditions where the sulfonamide drug is being used.

6. Some notes when using Chloroprocaine drug

Use of Chloroprocaine during pregnancy: animal reproduction studies have not been performed with Chloroprocaine. It is also not known whether Chloroprocaine can harm an unborn baby when administered to a pregnant woman or may affect fertility. Therefore, chloroprocaine should be used in pregnant women only when clearly needed. Use of Chloroprocaine in Labor and Delivery: Local anesthetics rapidly cross the placenta, and when used for epidural anesthesia, the cervix can cause varying degrees of maternal toxicity. , fetuses and infants. Use of Chloroprocaine in Lactation: It is not known whether Chloroprocaine is excreted in human milk. Since many drugs are excreted in human milk, caution should be exercised when chloroprocaine is administered to a nursing woman.

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