DOSAGE AND ADMINISTRATION
The dose of any local anesthetic administered varies with the anesthetic procedure, the area to be anesthetized, the vascularity of the tissues, the number of neuronal segments to be blocked, the depth of anesthesia and degree of muscle relaxation required, the duration of anesthesia desired, individual tolerance, and the physical condition of the patient. The smallest dose and concentration required to produce the desired result should be administered. Dosages of NOVOCAIN should be reduced for elderly and debilitated patients and patients with cardiac and/or liver disease. The rapid injection of a large volume of local anesthetic solution should be avoided and fractional doses should be used when feasible.
For specific techniques and procedures, refer to standard textbooks.
For infiltration anesthesia, 0.25% or 0.5% solution; 350 mg to 600 mg is generally considered to be a single safe total dose. To prepare 60 mL of a 0.5% solution (5 mg/mL), dilute 30 mL of the 1% solution with 30 mL sodium chloride injection 0.9%. To prepare 60 mL of a 0.25% solution (2.5 mg/mL), dilute 15 mL of the 1% solution with 45 mL sodium chloride injection 0.9%. An anesthetic solution of 0.5 mL to 1 mL of epinephrine 1:1,000 per 100 mL may be added for vasoconstrictive effect (1:200,000 to 1:100,000). (See WARNINGS and PRECAUTIONS.)
For peripheral nerve block, 0.5% solution (up to 200 mL), 1% solution (up to 100 mL), or 2% solution (up to 50 mL). The use of the 2% solution should usually be limited to cases requiring a small volume of anesthetic solution (10 mL to 25 mL). An anesthetic solution of 0.5 mL to 1 mL of epinephrine 1:1,000 per 100 mL may be added for vasoconstrictive effect (1:200,000 to 1:100,000). (See WARNINGS and PRECAUTIONS.)
THE USUAL TOTAL DOSE DURING ONE TREATMENT SHOULD NOT EXCEED 1,000 MG.
This product should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit. Do not use solutions if crystals, cloudiness, or discoloration is observed. Examine solution carefully before use. Reautoclaving increases likelihood of crystal formation. Solutions which are discolored or which contain particulate matter should not be administered.
Unused portions of solutions not containing preservatives should be discarded.
Pediatric Use:
In pediatric patients 15 mg/kg of a 0.5% solution for local infiltration is the maximum recommended dose.
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