Инфильтрационная, проводниковая, эпидуральная и спинномозговая анестезия; вагосимпатическая и паранефральная блокада; болевой синдром при язвенной болезни желудка и двенадцатиперстной кишки, геморрой, тошнота.
1 мл раствора для инъекций содержит прокаина гидрохлорида 5 мг;
Фармакологические свойства
Фармакологическое действие - местноанестезирующее.
Накапливается в мембранах нервных волокон и окончаний и взаимодействует с рецепторами, расположенными в потенциалзависимых натриевых каналах. Снижает проницаемость мембран для ионов натрия, препятствуя возникновению потенциала действия и проведению болевого импульса.
Показания к применению
Инфильтрационная, проводниковая, эпидуральная и спинномозговая анестезия; вагосимпатическая и паранефральная блокада; болевой синдром при язвенной болезни желудка и двенадцатиперстной кишки, геморрой, тошнота.
Противопоказания
Гиперчувствительность.
Способ применения и дозы
В/м — 5–10 мл 1–2% раствора 3 раза в неделю в течение месяца, после чего делают 10-дневный перерыв.
Для инфильтрационной анестезии применяют 0,25–0,5% растворы, для проводниковой и перидуральной — 2% раствор; внутрь — по 1/2 ч.ложки (при болях).
Симптомы: бледность кожных покровов и слизистых оболочек, головокружение, тошнота, рвота, повышенная нервная возбудимость, холодный пот, тахикардия, снижение артериального давления почти до коллапса, тремор, судороги, апноэ, метгемоглобинемия, угнетение дыхания, внезапный сердечно-сосудистый коллапс.
Действие на центральную нервную системы проявляется ощущением страха, галлюцинациями, судорогами, двигательным возбуждением. В случаях передозировки введение препарата следует незамедлительно прекратить. При проведении местной анестезии место введения можно обколоть адреналином.
Лечение: общие реанимационные мероприятия, которые включают ингаляцию кислорода, при необходимости проведение искусственной вентиляции лёгких. Если судороги продолжаются более 15-20 сек, их купируют внутривенным введением тиопентала (100-150 мг) или диазепама (5-20 мг). При артериальной гипотензии и/или депрессии миокарда внутривенно вводят эфедрин (15-30 мг), в тяжёлых случаях дезинтоксикационная и симптоматическая терапия.
В случае развития интоксикации после инъекции новокаина в мышцы ноги или руки рекомендуется срочное наложение жгута для снижения последующего поступления препарата в общий кровоток.
Взаимодействие с другими лекарственными средствами
Пролонгирует нервно-мышечную блокаду, вызванную суксаметонием (поскольку оба препарата гидролизуются холинэстеразой плазмы). Применение одновременно с ингибиторами МАО (фуразолидон, прокарбазин, селегелин) повышает риск развития артериальной гипотензии. Токсичность прокаина повышают антихолинэстеразные препараты (подавляющие его гидролиз). Метаболит прокаина (парааминобензойная кислота) является конкурентным антагонистом сульфаниламидных препратов и может ослабить их противомикробное действие. При обработке места инъекции местного анестетика дезинфекционным растворами, содержащими тяжёлые металлы, повышается риск развития местной реакции в виде болезненности и отёка. Потенциирует действие прямых антикоагулянтов. Препрат уменьшает влияние антихолинэстеразных средств на нервно-мышечную передачу. Возможна перекрёстная сенсибилизация.
Особые указания
В период лечения необходимо соблюдать осторожность при вождении автотранспорта и занятии другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций. Пациентам требуется контроль функций сердечно-сосудистой системы, дыхательной системы и центральной нервной системы. Необходимо отменить ингибиторы моноаминооксидазы за 10 дней до введения местного анестетика.
Форма выпуска
Раствор для инъекций.
Условия хранения
В защищенном от света месте, при температуре не выше 20 °C.
Срок годности
3 года.
Условия отпуска
По рецепту.
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