PROCAINE HYDROCHLORIDE INJECTION, USP
Procaine hydrochloride is benzoic acid, 4-amino-, 2-(diethylamino) ethyl ester, monohydrochloride, the ester of diethylaminoethanol and para-aminobenzoic acid.
NOVOCAIN is indicated for the production of local or regional analgesia and anesthesia by local infiltration and peripheral nerve block techniques.
The routes of administration and concentrations are: for local infiltration use 0.25% to 0.5% (via dilution) and for peripheral nerve blocks use 0.5% (via dilution), 1%, and 2%. (See DOSAGE AND ADMINISTRATION for additional information.)
Standard textbooks should be consulted to determine the accepted procedures and techniques for the administration of NOVOCAIN.
Media Articles Related to Novocain (Procaine Infiltration)
Does Adding Epidural to General Anesthesia Improve Survival in AAA Repair?
Source: Medscape Anesthesiology Headlines [2016.09.19]
Combining epidural and general anesthesia for abdominal aortic aneurysm repair is associated with improved survival and lower risk of complications, according to a recent study. But the associations may not hold up in the real world, other researchers suggest.
Reuters Health Information
Practical Aspects of Using Total Intravenous Anaesthesia
Source: Medscape Anesthesiology Headlines [2016.09.21]
What are the preferred agents for total intravenous anesthesia? For what procedures is it most appropriate? How should it be monitored? Learn the practical approach to TIVA in this article.
Published Studies Related to Novocain (Procaine Infiltration)
The effectiveness of triamcinolone acetonide vs. procaine hydrochloride injection in the management of carpal tunnel syndrome: a double-blind randomized clinical trial. [2011.04]
OBJECTIVE: Corticosteroid injection into the carpal tunnel is frequently used for the treatment of carpal tunnel syndrome (CTS). Steroids are usually mixed with local anesthetics, which have positive effects that can aid the treatment of CTS by inhibiting the spontaneous discharge ability of excitable cells. The aim of this study was 3-fold: (1) to determine the efficacy of triamcinolone acetonide injection in the treatment of CTS, (2) to determine the efficacy of procaine hydrochloride (HCl) in the treatment of CTS, and (3) to compare the efficacy of triamcinolone acetonide and that of procaine HCl in the treatment of CTS... CONCLUSIONS: Local procaine HCl injection and steroid injection effectively reduced the symptoms of CTS and equally improved electrophysiologic findings. As such, procaine HCl can be used in CTS patients in whom steroid use is contraindicated.
Comparison of bupivacaine and 2-chloroprocaine for spinal anesthesia for outpatient surgery: a double-blind randomized trial. [2011.04]
BACKGROUND: We have always been searching for the ideal local anesthetic for outpatient spinal anesthesia. Lidocaine has been associated with a high incidence of transient neurological symptoms, and bupivacaine produces sensory and motor blocks of long duration. Preservative-free 2-chloroprocaine (2-CP) seems to be a promising alternative, being a short-acting agent of increasing popularity in recent years. This study was designed to compare 2-CP with bupivacaine for spinal anesthesia in an elective ambulatory setting... CONCLUSION: Spinal 2-chloroprocaine provides adequate duration and depth of surgical anesthesia for short procedures with the advantages of faster block resolution and earlier hospital discharge compared with spinal bupivacaine. (ClinicalTrials.gov number, NCT00845962).
Chloroprocaine vs. articaine as spinal anaesthetics for day-case knee arthroscopy. [2011.03]
BACKGROUND: Chloroprocaine and articaine have recently gained interest as short-acting spinal anaesthetics. They have not, however, previously been compared in an ambulatory surgery setting... CONCLUSIONS: Both anaesthetics used provided a rapid onset of spinal anaesthesia of about 1 h and were satisfactory for day-case knee arthroscopy. Recovery, however, was significantly faster in group C40. The data add to earlier results that TNSs seem to be uncommon after spinal chloroprocaine and articaine. (c) 2010 The Authors. Journal compilation (c) 2010 The Acta Anaesthesiologica Scandinavica Foundation.
[Procaine infusion for pain treatment of acute pancreatitis: a randomized, placebo-controlled double-blind trial]. [2010.11]
BACKGROUND AND OBJECTIVE: Acute pancreatitis is commonly associated with severe abdominal pain, making early pain relief a primary goal of the treatment. This study was undertaken to assess the efficacy of a continuous intravenous (i.v.) infusion of procaine compared with that of a placebo infusion in providing pain relief in patients with acute pancreatitis.
The interaction between epidural 2-chloroprocaine and morphine: a randomized controlled trial of the effect of drug administration timing on the efficacy of morphine analgesia. [2009.07]
BACKGROUND: The efficacy and duration of epidural morphine analgesia is diminished when administered after 2-chloroprocaine compared with lidocaine. The mechanism of the interaction between 2-chloroprocaine and morphine is unknown... This suggests that the observed interaction between epidural morphine and 2-chloroprocaine is a result of differences in latency and duration of action of the two drugs, or that the administration of morphine before 2-chloroprocaine effectively blocks a receptor site antagonism.
Clinical Trials Related to Novocain (Procaine Infiltration)
Efficacy of the Combination Bismuth + Neomycin + Procaine in the Treatment of Recurrent Aphthous Ulceration [Completed]
To evaluate the efficacy of the product Bismu-Jet ® (bismuth tartrate and sodium, neomycin
sulfate and procaine hydrochloride) produced by EMS S / A compared to placebo in reducing
the signs and symptoms resulting from UAR in patients of both sexes, with age over 12 years.
Simplified Antibiotic Therapy for Sepsis in Young Infants [Completed]
This trial evaluates primary care clinic-based simplified antibiotic therapy options for
young infants, 0-59 days old in high neonatal mortality settings in peri-urban Karachi where
hospital referral is frequently refused by families.
Efficacy Study of Community-Based Treatment of Serious Bacterial Infections in Young Infants [Active, not recruiting]
Approximately one-third of neonatal deaths in developing countries are due to infections
acquired through the birth canal and/or exposure to an unclean environment soon after birth.
Current World Health Organization recommendations for the management of infants younger than
2 months of age who have serious bacterial infections involve hospitalization and parenteral
therapy for at least 10 days with antibiotic regimens containing penicillin or ampicillin
combined with an aminoglycoside. However, in many settings throughout the developing world,
this is not currently possible, nor is this standard of care likely to be feasible in the
near future. Several studies have reported that for a variety of sociocultural reasons many
families are unable or unwilling to access hospital-based care and their sick young infants
do not get hospitalized, and instead, receive a variety of home-based antibiotic therapies,
or none at all. In our community field sites, approximately 70% of families refuse hospital
referral for a sick newborn, despite provision of transport.
Thus, there is an urgent need to define the role of community/first-level facility-based
care versus hospitalization for the management of young infants with serious bacterial
infections, and the potential for community-based parenteral antibiotics as an alternative
strategy in resource poor areas with high neonatal mortality rates. Bang and colleagues have
demonstrated significant reductions in neonatal mortality from infections in an
underdeveloped rural district in Maharashtra, India by a field-based case management
approach which used oral cotrimoxazole and intramuscular gentamicin given for 7 days as
treatment for neonates with sepsis.
This study is an equivalence randomized controlled trial (RCT) comparing once daily IM
ceftriaxone injection to once daily IM procaine penicillin and gentamicin injection, to once
daily intramuscular gentamicin injection and twice daily oral cotrimoxazole, given for 7
days in babies with clinically-diagnosed possible serious bacterial infection (pneumonia, or
sepsis with or without local infections such as skin or umbilical infections) whose families
refused referral to a hospital. After supplementary informed consent, patients meeting
specific inclusion and exclusion criteria are randomly allocated to one of the three
regimens being tested. The study hypothesis is that all 3 regimens will perform equally well
in the treatment of sepsis in a first-level facility setting.
A Dose Response and Safety Study of Procaine HCl in HIV-Infected Patients [Completed]
This a Phase I/II non-randomized, open-label clinical study of 8 weeks duration using SP01A
in HIV positive patients on a stable antiretroviral regimen. Dose response and safety
associated with oral administration of four doses (200 mg, 400 mg, 600 mg, and 800 mg daily)
of SP01A will be studied in a total of 24 study subjects. In addition, six HIV-negative
subjects will be recruited as a control for cortisol secretion only and will not receive
Simplified Antibiotic Regimens for Outpatient Treatment of Suspected Sepsis in Neonates and Young Infants in Bangladesh [Completed]
The primary aim is to establish the non-inferiority of several simplified, home-based
antibiotic regimens compared to the standard course of parenteral antibiotics for the
empiric treatment of suspected sepsis in Bangladeshi young infants whose parents refuse
hospitalization. Three alternative regimens will be compared with a standard (reference)
regimen of injectable procaine-benzyl penicillin and gentamicin once daily each for seven
days. Alternative regimens are (1) injectable gentamicin once daily and oral amoxicillin
twice daily for seven days; (2) injectable penicillin and gentamicin once daily for two days
followed by oral amoxicillin twice daily for five days; and (3) injectable gentamicin once
daily and oral amoxicillin twice daily for two days followed by oral amoxicillin twice daily
for five days.
The proportion who fails treatment will be 10 percent in the reference group and the
alternative treatment groups. An alternative therapy will be considered non-inferior to the
standard therapy if the failure rate in the alternative therapy exceeds the failure rate in
the injectable therapy by less than 5 absolute percentage points.
- To identify baseline clinical predictors of treatment failure in severe infections in
- To determine the proportion of relapse (young infants who were considered cured by day
7 but developed any of the signs of suspected severe infection by day 14).
Reports of Suspected Novocain (Procaine Infiltration) Side Effects
Drug Hypersensitivity (10),
Chest Discomfort (1),
Respiratory Distress (1)