Indication:
Spinal anesthesia
Spinal anesthesia
Injectable Local Anesthetics include-
Amide Local Anesthetics-
Bupivacaine hdrochloride, Lidocaine hydrochloride,Mepivacine hydrochloride
Prilocaine hydrochloride,Ropivacaine hydrochloride
Ester Local anesthetics-
Chloroprocaine hydrochloride,Procaine hydrochloride,Tetracaine hydrochloride
Refer -Procaine
Pharmacology/ Pharmacokinetics:
Injectable Local Anesthetics include-
Amide Local Anesthetics-
Bupivacaine hdrochloride, Lidocaine hydrochloride,Mepivacine hydrochloride
Prilocaine hydrochloride,Ropivacaine hydrochloride
Ester Local anesthetics-
Chloroprocaine hydrochloride,Procaine hydrochloride,Tetracaine hydrochloride
Refer -Procaine
Pharmacology-
These agents prevent generation of conduction of nrtve impulses by inhibiting ionic
fluxes, increasing electrical excitation threshold, slowing nerve impulse propagation,
and reducing rate of action potential . Progression of anesthesia is related to the
diameter, myelination, and conduction velocity of affected nerve fibers. The order
of loss of nerve function is - Pain, temparature, touch, proprioception, and skeletal
muscle tone.
Pharmacokinetics -
Various pharmacokinetic parameters cen be significantly altered by the presence
of hepatic or renal disease , addition of epinephrine, factors affecting urinary pH,
enal blood flow, administration route and age of patient, and the presence or absence
ephinephrine in the anesthetic solution.
Injectable Local Anesthetic Pharmacokinetics
Onset Duration Equivalent pKa Partition Systemic
(min) (hours) anesthetic coefficient protein
conctrn binding
(%) (%)
Anesthetic
Esters
Procaine
2.5 0.25-1 2 9.1 0.02 5.8
(+epinephrine)
nd 0.5-1.5
(Epidural)
15-25 0.5-1.5
Chloroprocaine
6-12 0.5 2 9 0.14 nd
(+epinephrine)
nd 0.5-1.5
(Epidural)
5-15 0.5-1.5
Tetracaine
<15 2-3 0.25 8.5 4.1 75.8
(Epidural)
20-30 3-5
(Spinal)
nd 1.25-3
Amides
Lidocaine
<2 0.5-1 1 7.9 2.9 64.3
(+epinephrine)
<2 2.6
(Epidural)
5-15 1.3
(Spinal)
nd 0.5-1.5
Prilocaine
<2 >1 1 7.9 0.9 55
(+epinephrine)
<2 2.25
(Epidural)
5-15 1-3
Mepivaciane
3-5 0.75-1.5 1 7.8 0.8 77.5
(+epinephrine)
nd 2-6
(Epidural)
10-20 3-5
(Spinal)
nd 0.5-1.5
Bupivacaine
5 2-4 0.25 8.2 27.5 95.6
1565
(+epinephrine)
nd 3-7
(Epidural)
10-20 3-5
(Spinal)
nd 1.25-2.5
Lovobupivacaine
- - - 8.09 1624 >97
(Epidural)
~10 ~8
Ropivacaine
- - nd 8.07 2.9 94
(Epidural)
1030 0.5-6
