Tetracaine/An Ester Nerve-blocking Local Anesthetic
Tetracaine/An Ester Nerve-blocking Local Anesthetic
Tetracaine is an ester nerve block local anesthetic, which is highly toxic and can penetrate the mucous membrane. Its local anesthetic effect is stronger than that of procaine, more than ten times that of procaine, and it can take effect within 1-3 minutes. The effect can be maintained for 2-3 hours, with strong penetrating power. It is mainly used for mucosal anesthesia, such as topical anesthesia of eyes, nose, throat and urinary tract. Absorption can cause convulsions, and then turn into respiratory depression, so infiltration and conduction anesthesia are generally not performed.
For epidural block, subarachnoid block, nerve conduction block, mucosal surface anesthesia.
Dosage
Epidural anesthesia: The usual concentration is 0.15-0.3% solution, combined with lidocaine hydrochloride, the highest concentration is 0.3%, the usual dose is 40-50 mg, and the extreme dose is 80 mg.
Subarachnoid space block: commonly used its mixed solution (1% tetracaine hydrochloride 1ml mixed with 10% glucose injection 1ml, 3% ephedrine hydrochloride 1ml), the usual dose is 10mg, 15mg is the limit, 20mg is the extreme quantity.
Nerve conduction block: the usual concentration is 0.1% to 0.2%, the usual dose is 40 to 50 mg, and the extreme dose is 100 mg.
Mucosa topical anesthesia: commonly used concentration is 1%, 1% isotonic solution for ophthalmology, 1-2% solution for otolaryngology, and the limit is 40 mg at a time.
Adverse Reactions
Toxic reaction: The efficacy of this product is 10 times that of procaine, and its toxicity is also 10 times higher than that of procaine. The incidence of toxic reactions is also higher than that of procaine. Often due to large doses, rapid absorption or improper operation, such as mistakenly injecting into blood vessels so that the blood concentration is too high.
Symptoms of overdose poisoning are: dizziness, dizziness, followed by chills, tremors, panic, and finally convulsions and coma, and respiratory failure and blood pressure drop, requiring timely rescue.
Allergic reaction: It can cause sudden death in allergic patients, and attention should be paid even during topical anesthesia. Rashes or urticaria, edema of the face, mouth or (and) glossopharyngeal area may occur.
Taboo
Those who are allergic to this product are prohibited. Those with severe allergies are forbidden. Patients with cardiac and renal insufficiency and myasthenia gravis are prohibited. Prohibited for infiltration local anesthesia, intravenous injection and intravenous infusion.
Precautions
1. This product is an ester local anesthetic, and allergic reactions are rare. It may have a cross-allergic reaction with procaine, so people who are allergic to procaine or drugs with p-aminobenzoic acid structure should use it with caution.
2. Large doses can cause inhibition of the cardiac conduction system and central nervous system.
3. The liquid medicine must not be injected into the blood vessel. Repeated aspiration is required during the injection to avoid blood return.
4. Toxic reactions are likely to occur in children, the elderly and infirm, malnourished, and starvation states, and the dosage should be reduced.
5. Hepatic insufficiency, when plasma cholinesterase activity weakens, the dose should be reduced.
6. It should be used with caution in areas with skin or mucous membrane surface damage and severe infection.
7. During spinal anesthesia, it is especially necessary to adjust the block plane, and observe changes in blood pressure and pulse at any time.
8. Nerve conduction block, epidural block and subarachnoid block, death due to improper use has been common; in order to prevent poisoning and death, even superficial mucosal anesthesia should be monitored during medication: ① Respiratory and circulatory system functional status, including cardiovascular status. ②Central nervous activity, excitement or inhibition. ③ fetal heart rate. At the same time, accidents in breathing and circulation should be foreseen, detected in time, prevented and rescued properly, without time delay.
9. The toxicity of this product is related to the route of administration, the speed of administration, the concentration of the drug solution, the site of injection, whether or not to add epinephrine, etc. It must be strictly operated and managed, the dosage per unit time should be controlled, and the drug should be administered according to the introduction of this manual.
10. After giving the maximum dose, rest for more than 3 hours before taking action.
11. Injection equipment cannot be washed and disinfected with alkaline substances such as soap, creol soap solution, etc.
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