Why is novocaine injected into the bone marrow canal. Indications for use. Storage conditions and shelf life

Of all the systems, organs and tissues on which novocaine has an effect, researchers are primarily attracted to the central nervous system.

There are numerous indications in the literature about the ability of novocaine to have both direct and reflex effects on the central nervous system.

On the central influence novocaine indicate peculiar changes in higher nervous activity in people with intravenous and intra-arterial administration of novocaine, expressed in the appearance of visual and auditory hallucinations, unusual interoreceptive sensations, some lethargy, etc. .

The reduction obtained in the clinic and in the experiment pain sensitivity from intravenous infusions of novocaine, some authors also associate with the effect of the drug on the central nervous system.

Of interest are studies in which an attempt was made to analyze the effect of novocaine on the central nervous system by studying the body's reaction to it in various stages ontogenetic development. In experiments on rabbits, it was found that the reaction in the form of general motor inhibition occurs in the embryonic period and in the first 10 days. postnatal period, and the reaction in the form of general tonic and tonic-clonic convulsions occurs from the 15th day of the postnatal period and at all subsequent ages.

Comparing the specified pharmachologic effect novocaine with terms of formation of function various departments central nervous system in ontogenesis, the authors came to the conclusion that the general motor inhibition that occurs from novocaine in embryos and young rabbits is associated with an effect on lower divisions central nervous system (dorsal, oblong and midbrain), and novocaine convulsions in older rabbits are associated with an effect on the overlying parts of the brain.

The effect of novocaine on the centers of the diencephalon is indicated by studies on the study of its convulsive action. In experiments on rabbits, it was found that, while maintaining the diencephalon, convulsions due to subcutaneous injection novocaine in doses of 200-400 mg / kg occurs even when the cerebral cortex is removed or when it is highly transversely cut (the cut plane passed obliquely through the hemispheres towards olfactory tract). Novocaine does not cause convulsions in spinal rabbits.

There is still no consensus in explaining the mechanism of action of novocaine on the central nervous system.

Many researchers consider the development of an inhibitory process in the central nervous system to be the dominant effect in novocaine therapy. Based on the study of electrocerebrograms and shifts in motor chronaxy in rabbits, it was found that intravenous administration of novocaine causes significant inhibition of the higher parts of the central nervous system.

Pararenal and subcutaneous novocaine blockades create less stable phase changes in the nervous; processes in the central nervous system, but even with these types of blockades, the predominance of the inhibition process can be noted.

Similar results were obtained when studying the effect of epidural, intraperitoneal and pararenal novocaine blockades on the processes of inhibition in the cerebral cortex, in dogs against the background of developed conditioned salivary reflexes and differentiations.

In experiments on intact rabbits to study the effect of anesthetics on the process of summation in the central nervous system, it was found that novocaine increases the threshold of perception and complicates the process of summation of painful stimuli. Due to the fact that the summation of pain stimuli is usually associated with the activity of the midbrain, it is believed that novocaine also has an inhibitory effect on this part of the central nervous system.

However, according to other researchers, novocaine has an inhibitory effect mainly on cortical processes and to a lesser extent acts on the underlying parts of the brain.

As for the mechanism of development of inhibition in the central nervous system, a number of authors consider it with the intravenous method of using novocaine as a result of inhibition of interoreceptive and, above all, vascular zones by novocaine. In their opinion, the shutdown of the extensive vascular field of the pulmonary circulation by intravenous novocaine, from which centripetal stimuli normally come in a powerful stream all the time, changes the functional state of the corresponding centers of the cortex. With deprivation a large number irritation, the corresponding centers may be in a state of passive inactivity. Their working tone, performance are falling. Now, in these centers with reduced tone, with reduced efficiency, transcendental sleep inhibition easily develops in the usual manner.

Other researchers believe that the most important in the action of novocaine on the central nervous system is the inhibition of the transition process nervous excitement in the area of ​​synaptic connections between neurons.

There is evidence of the effect of novocaine on reflex activity spinal cord. In experiments on cats under light urethane anesthesia, it was found that novocaine administered intravenously blocks the transmission of excitation in reflex arcs. lumbar spinal cord, affecting primarily the intercalary neurons of these arcs. The most sensitive to novocaine is the cross extensor reflex, then the flexion reflex, and finally the knee reflex.

Thus, a significant group of researchers considers the development of an inhibitory process in the central nervous system to be the dominant effect in novocaine therapy.

However, there is evidence in the literature that novocaine also increases the excitatory process of the cerebral cortex. Using the method of optical adequate chronaxis, it was found that intraperitoneal administration of novocaine in patients with peptic ulcer increases the excitatory process of the cerebral cortex and, according to the law of negative induction, causes depression of the subcortical centers. This leads to the normalization of cortical-subcortical relationships and creates favorable conditions for ensuring normal functional activity. internal organs and the whole organism as a whole. The appearance of dysrhythmias in the pattern of brain biocurrents also testifies to the intensification of the irritative process in the cerebral cortex after the administration of novocaine.

Based on plethysmography data, it is believed that novocaine blockade in peptic ulcer disease in humans has a normalizing effect on both processes, both excitatory and inhibitory. The action of novocaine in this case depends on functional state cerebral cortex.

In experiments using the technique of conditioned salivary-secretory reflexes with food reinforcement, the effect of various doses novocaine when administered subcutaneously on higher nervous activity in dogs. According to the author, novocaine causes an increase in the irritative process in the cerebral cortex of dogs, which manifests itself at low doses (1-2 mg / kg) in an increase conditioned reflexes for all irritants. Slightly large doses of novocaine (5 mg/kg), intensifying the irritable process to a greater extent, lead to the fact that excitation from strong conditioned stimuli exceeds the working capacity of the cells of the cerebral cortex and there is an outrageous protective inhibition (reflexes are preserved). In this case, excitation from weak conditioned stimuli reaches only the limit of working capacity (reflexes do not change). A further increase in the dose of novocaine (20 mg/kg) causes prohibitive inhibition of all stimuli. The duration of the above change in conditioned reflex activity after small and large doses of novocaine depends on the type of nervous system of dogs and ranges from 1 to 7 days.

There are reports that the effect of novocaine on the central nervous system depends on the method of administration, in particular, when intravenous administration the drug, the phase of excitation of the cortex and centers predominates, and with intra-arterial, the state of inhibition of the cerebral cortex predominates.

Based on the foregoing, it can be concluded that there is no consensus on the interpretation of the mechanism of action of novocaine on the central nervous system. All researchers acknowledge that novocaine has a normalizing effect on the functional state of the central nervous system. However, many aspects of the action of novocaine remain insufficiently studied, and information on the effect of novocaine on the central nervous system in farm animals is generally absent in the literature.

In this regard, we were tasked to study the effect of novocaine on some functions of the central nervous system in a horse, a large cattle and dogs. To solve this problem, experimental studies, which studied the effect of novocaine on the cerebral cortex, on the excitability of the peripheral neuromuscular apparatus, on the reflex apparatus of the medulla oblongata and spinal cord, as well as on the excitability and tone of the centers of the vagus nerves. 32 horses were used in the experiments; 22 cattle, 6 sheep and 56 dogs.

In experiments on horses, it was found that responses from blood pressure, pulse, respiration and body temperature for intravenous administration of novocaine under anesthesia and in intact animals are not the same. If the introduction of 2.5-5 mg / kg of novocaine causes an increase in blood pressure and body temperature in non-anesthetized animals, an increase in heart rate and respiration, then when it is used against the background of anesthesia, these reactions are mild or absent. Since chloral hydrate is a cortical hypnotic, the facts obtained allow us to assert the participation of the cerebral cortex in the body's responses to intravenous administration of novocaine. In addition, the results of the experiments indicate the dependence of the action of novocaine on the animal body on the initial functional state of the central nervous system.

The results of the chronaximetric study make it possible to judge the nature of functional changes in the Central Nervous System. Chronaxia in all experimental animals after intravenous administration of novocaine at a dose of 2.5-5 mg/kg increased significantly. In horses, it increased on average from 0.023 m / s to 0.117 m / s, i.e. 5 times, in cattle - from 0.018 to 0.081 m / s, i.e. 4.5 times, and in sheep - 0.120 to 0.472 m / s, i.e. 3.9 times. Chronaxia indicators usually returned to the initial level in horses after 47-72 hours, and in cows and sheep - for 3-4 days.

The pronounced and persistent lengthening of the motor chronaxia of the external levator ear revealed in these experiments after intravenous administration of novocaine at a dose of 2.5-5 mg/kg indicates the development of inhibition in the higher parts of the central nervous system.

This conclusion is quite consistent with the literature data on the dependence of peripheral chronaxia on the functional state of the central nervous system, as well as with indications that under the influence of excitation processes occurring in the central nervous system, chronaxia decreases, and under the influence of inhibition processes it increases.

Interesting data were obtained in experiments on dogs when studying the effect of intravenous infusions of novocaine at a dose of 10 mg/kg on the non-reflex apparatus of the medulla oblongata.

With irritation of the peripheral and central segments vagus nerve electric shock from the sledge apparatus, the ability of novocaine to lower both reflex and direct excitability of the reflex apparatus of the vagus nerve was revealed, with the former falling more strongly.

A decrease in the reflex excitability of the vagus nerve indicates the development of inhibition in the central nervous system, which also spreads to the medulla oblongata.

In another series of experiments on dogs, the ability of novocaine, when administered intravenously at a dose of 10 mg/kg, was revealed to reduce the response of blood pressure and respiration to the administration of a small standard dose of lobelin, which indicates a decrease in the excitability of the respiratory and vasomotor centers.

The nature of functional changes in these centers depends on the dose of novocaine. If in experiments with lobelin it was found that with the introduction of novocaine at a dose of 10 mg / kg, functional changes in the state of the respiratory and vasomotor centers develop towards the inhibitory process, then in experiments on studying the effect of novocaine on blood pressure, lower dosages of novocaine (2.5 -5 mg/kg) caused a short-term and slight increase in blood pressure, which indicates the excitation of the vasomotor center.

Consequently, intravenous administration of novocaine in small doses causes reactions indicating excitation of the vasomotor center, and in large doses - its inhibition. The relatively short duration of pressor and depressor reactions on the part of arterial pressure and their interchangeability indicate the mobility of the processes of excitation and inhibition in the central nervous system.

Our data on phase changes in the function of nervous structures under the influence of novocaine are also confirmed by literary reports. So, for example, along with the phenomena of excitation in the nerve conductors, detected by the electrophysiological method, motor excitation of animals and contraction of the muscles of the limbs are observed. In the study of bioelectric oscillations in the sensory nerve under the influence of a short novocaine blockade, some increase in the electrical activity of the nerve was noted in the first 20-50 seconds, which decreased after 1-2 minutes and disappeared completely by 5-10 minutes.

When studying the excitability of individual links of the reflex apparatus of the spinal cord by determining the threshold of irritation of the peripheral segment sciatic nerve(direct excitability) and the central segment of the femoral cutaneous nerve (reflex excitability), we revealed the ability of novocaine when administered intravenously in dogs at a dose of 10 mg/kg to inhibit spinal reflexes. It was shown that novocaine acts mainly on the central link reflex arc and less on its motor part.

Thus, the analysis of our own and literature data allows us to conclude that the nature of functional changes in the central nervous system depends on its initial state, the dose of novocaine, and, apparently, a number of other, still insufficiently studied factors. However, the dominant effect when using novocaine at doses of 2.5-5 mg/kg in horses, cattle and sheep, according to our data; is the development of the inhibitory process in the central nervous system.

Along with this, when studying the effect of novocaine on blood pressure, the ability of this anesthetic to certain conditions experience strengthen in the central nervous system and excitation processes.

Remember, somewhere in the 80s, the news thundered - novocaine prolongs life by 20% ?!
And the Soviet people began to buy it in pharmacies, shake the ampoules into a tablespoon and lick it off, drinking clean water.
I tried it too, but found an unexpected side effect and had to stop. More about this below, in Contraindications :)

· It not only anesthetizes. Although removing the pain is powerful remedy. Already in the 21st century, surgeons discovered that pain prevents the body from healing itself, and if it is reliably removed, then recovery occurs an order of magnitude faster. Then the term was born pathogenetic therapy", when the elimination of symptoms leads to getting rid of the disease itself.

It heals the nervous system.

· Normalizes the circulatory system.

· Treats hypertension, tk. relieves spasms smooth muscle, relieves hypertonicity of the muscles of the face, neck, head (and tremor at the same time).

Excellent treatment of gangrene (the discovery was made by military surgeon Marinov Alexander Vladimirovich. He once had to interrupt the amputation of a gangrenous foot - there was an urgent evacuation. A few days later he found a soldier with a revived foot - novocaine preoperative blockade saved the leg from gangrene).

Very powerfully restores the proper nutrition of cells - the body begins a healthy assimilation of the necessary substances from food.

Antifungal - this is well tested, I have an article " interdigital fungus”, look.

In animal experiments, markedly increases the lifespan of males (but not females)

In animals, the number of occurrence of all kinds of tumors is sharply reduced compared to the control group

· Anti-cancer. A point-projection of a diseased organ is found on the spine (it is easy to find because it is always painful), and half-percent novocaine and intramuscularly vitamin B1 are injected subcutaneously on the right and left. A course of 46 procedures, at any stage. There were no failures. This was written by Alexander Ivanovich Romanovsky, a psychiatrist, manuologist. Now retired, but works in a psycho-neurological dispensary in Moscow. Treats cancer.

Recommendation of the Institute of Gerontology of the Academy of Medical Sciences of Ukraine: The treatment cycle includes 12 injections of 2% novocaine solution, 5 ml every other day; a break between the first three cycles - 10 days, between the next - from 1 to 3 months (3-4 cycles per year). A test should be done the day before the start of treatment. subcutaneous injection 0.5 ml of a 2% solution of novocaine to determine sensitivity to it.

For maintenance therapy, it is customary to take novocaine or inject every 3 or even 23 days.

Contraindications: only hypotension and allergies. And for women - loneliness. Novocaine, taken orally, in a few minutes causes an urgent need, uh ... to get married immediately. I know for myself. In my youth, I don’t remember for what reason I took a novocaine cube ... Then I was alone, and I had to run to the beach and jump from the buna into the sea for about half an hour and swim in the butterfly style to get distracted :) I do not exclude that it was my purely individual reaction;))

No streptocides and sulfonamides, they are incompatible with novocaine.

Almost half a century was spent by scientists from the Institute of Gerontology at the Academy of Sciences of Ukraine to investigate the effect of various substances on the rate of aging of the body. Among the substances tested were vitamins, placenta preparations, various substances produced by glands internal secretion, as well as novocaine.

Surprising were the data obtained on the action of novocaine. It turned out that this drug in terms of efficiency reaches the action of vitamins. This is due to the fact that its main component is para-aminobenzoic acid. This substance is necessary for the work of a living organism of warm-blooded creatures. Para-aminobenzoic acid, present in the composition this drug, is needed for the work of the reproductive organs, work thyroid gland and other endocrine glands. The presence of this substance in the body helps not to reduce the activity of these organs over time.

This substance not only stops the aging of some systems and organs, it can also be used to treat many senile diseases, but only together with other drugs. In such hyped brands as gerovital or aslavital, the main active component is novocaine.

Anti-aging drugs based on novocaine are also produced in combination. As part of such funds there are also vitamins. You can also take such drugs separately, and separately vitamin and mineral dietary supplements (biologically active additives) corresponding to the age. Plus use similar drugs in that there are practically no side effects.

Old age is a disease, and it is curable! An interesting monograph "Age Biology" was published in Romania - the result of many years of research by the famous Romanian scientist Konstantin Parkhon. The specialist argues that old age should not be considered normal state organism, but pathology. The main role in this process, in his opinion, is played by the endocrine glands.

A little more, and Dr. Aslan's patients (see sidebar) will turn into ... (Photo by Owen Franken / Corbis.)

Thanks to careful clinical research and experiments, Academician Parkhon revealed the role of each endocrine gland in the process of aging and came to the conclusion that old age can and should be treated. For the treatment of old age, Konstantin Parkhon uses extracts of goiter, thyroid gland, as well as the epiphysis, adrenal glands and a number of other drugs, including vitamins E, B and novocaine, which he calls vitamin H3.

AT last years these studies have been widely disseminated. For example, Professor Ana Aslan from the Institute for the fight against old age (Romania) is experimenting with 110 old people who live in a local hospital. All of them undergo different courses of treatment with hormones, vitamins, extracts from gland tissues, baths with bicarbonate soda and novocaine. Here are some results of this unique work.

Professor Aslan almost recalls with horror what a painful impression the visit to the nursing home made on her: “We observed helplessness and deep despondency; the sound of crutches and sticks was heard in the long corridors. Now the old people from this orphanage are in the care of her institute. And a miracle happened: it became quiet in the corridors - there were simply no patients who would walk on crutches or with a stick! People who once almost lost human form, actively get rid of the phenomena accompanying old age. And if an old man good memory, normal hearing and vision, smooth, wrinkle-free skin, strong muscles, then can this be called old age?

Research at this institute is carried out by specialists with professional education and is aimed at the prevention and treatment of old age. More than a hundred elderly patients were at the disposal of scientists. First of all, they examined physical state in terms of clinical, physiological, biochemical and hematological parameters. After that, patients were prescribed treatment with hormones, vitamins, extracts from various tissues, as well as carbonic baths. The best - yes there, unique! - the results were achieved by the introduction of novocaine.

Amazing results

Novocaine, we recall, was discovered in 1905; until about the early 1950s, it was used only for pain relief in surgical operations and as a medicine various diseases, for example, in the treatment of rheumatism and circulatory disorders (introduced by intra-arterial, and sometimes intravenous infusions). So, the use of banal novocaine in the treatment of old people from a nursing home, according to doctors, significantly improved them. general state: pathological phenomena characteristic of Parkinson's disease (trembling of hands and feet), insufficient flexibility of the body decreased. In addition, attention and memory have improved. Experiments on mice only confirmed the effect of this remedy: the skin of experimental animals acquired its former luster, body weight increased ...

In the end, Romanian specialists ventured into long-term continuous treatment with novocaine twenty-five old people. For two years, no one died, although among them were people aged 60 to 92 who suffered from serious illnesses heart, nervous system, atherosclerosis and parkinsonism; some of them were completely disabled.

"We conquer old age"

But all this beautiful words, without examples, the reader will never believe in the miraculousness of the newly invented therapy. And they are. When patient V. entered the Institute for the fight against old age, she was already 92 years old. She had a body hunched from illness and age, a wrinkled face, dull eyes, trembling hands, thickened and twisted arteries, completely gray hair, poor eyesight and hearing; the pale skin on the face and hands was covered with numerous spots that appear in old age; memory is weakened - she did not even remember the names of her children. Blood pressure- 220 to 115 mmHg Art. She could not bend at all... Six years have passed, and V. is no less flexible than in her youth, she hears well again and can sew without glasses. Her eyes amaze with unusual liveliness for her age. Among the patients observed at the institute, she stands out for her cheerfulness, cheerfulness and cheerfulness. The signs of old age disappeared from her face, her eyebrows darkened, her skin became smooth, her muscles were elastic. She makes her own toilet, cleans the room and goes for walks around the city alone. hairline the head recovered by 90%, the gray strands partially acquired their previous color.

“Perhaps someday only from books will they learn that earlier people turn gray to old age,” notes Professor Aslan.

Despite the fact that V. is now 97 years old, she feels quite healthy. Her body has rejuvenated. After treatment, she recovered by 4.5 kg, blood pressure dropped to 190 per 100 mm Hg. Art.

One more case. Patient H., a single woman, was 64 years old when she entered the institute. She had glaucoma in both eyes, which had a depressing effect on her mood. She suffered from insomnia and slept no more than 2-3 hours at night. Paralysis chained her to bed. The blood pressure was very high, the memory was useless ... To cure the paralysis, it turned out to be enough to give a course of novocaine injections. Muscle strength gradually increases, memory improves. She sleeps again at night for 7-8 hours. Hair stopped falling out. H. got younger. She wanted to work, and now she works as a paramedic.

Now a few words about Professor Ana Aslan's oldest patient. This is M., he is 109 years old. Once he was a port worker; he was brought to the institute from a nursing home in the deepest depression. “A cursory glance was enough,” recalls Ms. Aslan, “to guess his age: completely gray hair, trembling hands, darkened skin, lack of body flexibility ... Thinking was slow. He hardly remembered anything. I couldn't leave the room without outside help...” And what about him now, after a three-year stay at the institute? H. at any time walks around the yard or along the nearest streets, and you will never believe that he is 109 years old! Lively and cheerful, he loves to talk about his youth. His memory has been restored. The skin has brightened, and the hair is almost the same color as in youth.

Vitamin H3

Today, out of 180 old people who are at the Institute for the fight against old age, about 125 are undergoing treatment with novocaine. 1,017 people aged 45 to 50 receive preventive treatment on an outpatient basis or at home under medical supervision. The method of treatment is as follows: three times a week, the patient is injected with five cubic centimeters of a two percent solution of novocaine. The course lasts four weeks. After a ten-day break, treatment is resumed. Novocaine also has a beneficial effect in the treatment of stomach ulcers, skin pigmentation disorders and hair loss.

During therapy, patients experience a strengthening of the central nervous system, which is expressed in an increase in interest in life, work, environment. In addition, novocaine affects the endocrine glands, balancing their activity.

Finally, novocaine has a special property: it turns in the body into two chemicals, one of which is an amino acid, otherwise called vitamin H1 (or H2). The vitaminizing effect of novocaine, scientists explain, affects the excitation of the intestinal bacterial flora, which contributes to the creation of vital substances in the body. The influence of novocaine should be attributed to the restoration mental abilities, an increase in muscle and physical strength, increase resistance to aging. To emphasize the vitaminizing effect of novocaine, the researchers proposed to call it "vitamin H3".

Prepared based on the materials of the journal "Knowledge is power".

From this article you will learn:

• how effective is novocaine,
• which is better - novocaine or lidocaine,
• is it possible to dilute ceftriaxone with novocaine, or cefazolin ...

Novocain is an anesthetic that was widely used in the USSR for local anesthesia, both when extracting teeth, opening purulent abscesses, and for carrying out any operations under local anesthesia.

Novocain: key characteristics

Novocaine - instructions for the use of this drug contains the following key characteristics that do not allow more massive use of this local anesthetic, in view of its shortcomings and the appearance of much more modern drugs for anesthesia.

Disadvantages of novocaine –

• weak analgesic effect,
• lack of analgesic effect in inflamed tissues,
• short duration of anesthesia,
• high allergenicity and toxicity to the body,
• you can not use novocaine during pregnancy or feeding categorically!

Novocaine: price and release forms
Novocaine ampoules may contain either a 0.5% solution or a 2% solution. The cost of 1 package of novocaine (10 ampoules of 5 ml) will be approximately 30-50 rubles.

In the 90s, novocaine was replaced by an anesthetic, which is still widely used in medicine and dentistry in particular. Lidocaine is 2 times stronger than novocaine in terms of the depth of anesthesia and the duration of the effect, and it also works well in inflamed tissues. Significantly lower allergenicity and toxicity of the drug.

Modern analogues of novocaine in dentistry -

Despite the still widespread use of lidocaine in medical practice, dentistry has long moved away from this anesthetic as well. most effective for this moment are anesthetics based on articaine. Such anesthetics include:, Ubistezin, Septanest, etc.

These drugs for local anesthesia are no longer available in ampoules, like novocaine or lidocaine, but in special carpules (Fig. 2). The anesthetic cartridge is already ready for use, it does not need to be opened; it is inserted into a special cartridge syringe (Fig. 1), and then a needle is screwed into the syringe with the cartridge (Fig. 3).

The use of novocaine for electrophoresis, compresses and dilution of antibiotics -

Electrophoresis with novocaine is not very effective. It is best to use the anesthetic Lidocaine 2% for electrophoresis (sold in 2 ml ampoules).

Compress with dimexide and novocaine -

Dimexide compresses are very often prescribed by maxillofacial surgeons, especially when traumatic injuries face (fractures of the bones of the face, without the presence of open wounds). Compresses are very good effect and, for example, are able to reduce swelling and inflammation of soft tissues in case of a jaw fracture in just a few procedures.

Dimexide with novocaine compress: proportions
a compress with dimexide and novocaine is used only externally. When applying a compress on the face, you need to use a 20-25% concentration of dimexide. To do this, dilute dimexide in proportion: for 1 part of dimexide - three parts of warm boiled water. When applied to less sensitive areas of the body, more concentrated solutions (30, 35, 40%) can be used.

Moisten gauze pads with a solution diluted with water. Directly on moistened wipes, apply the contents of 1 ampoule of novocaine (5 ml of solution). Attach the wipes to the desired area. A plastic film must be applied over the napkin, completely covering the area of ​​​​the applied gauze napkin with the solution. Apply a layer of fabric over the polyethylene (the thicker the fabric, the stronger the thermal effect will be - keep this in mind!) and bandage it.

The time of one compress is 20-30 minutes. The course of treatment is 10-12 procedures (1 procedure per day). From experience, we can say that to enhance the analgesic effect, it is better to use not novocaine, but lidocaine (2-4 ml of lidocaine per 1 compress). Lidocaine penetrates the skin better, is less allergic, and its analgesic effect is 2 times stronger.

Dimexide: how to apply a compress (photo 4-6)

How to dilute ceftriaxone with novocaine -

The antibiotic Ceftriaxone is undesirable to dilute with novocaine, because. the antibiotic itself is quite allergic, and novocaine increases the risk of developing anaphylactic shock many times (compared to lidocaine). It is optimal to dilute ceftriaxone with a solution (this is also recommended by WHO). This anesthetic is much less allergic, and has a stronger analgesic effect.

It is necessary to dilute 500 mg of ceftriaxone in 2-2.5 ml of a solvent. For dilution of 1000 mg of ceftriaxone - 3.5-4 ml of solvent. As the latter, either water for injection or 0.5-1% novocaine solution can be used, but 1% lidocaine solution is best. But, to dissolve ceftriaxone in lidocaine, you still have to use water for injection, because. the concentration of lidocaine in ampoules is 2%.

Tradename: Novocaine

International non-proprietary name:

Pharmacodynamics
A local anesthetic with moderate anesthetic activity and a wide range of therapeutic effects. Being a weak base, it blocks Na + channels, prevents the generation of impulses at the endings of sensory nerves and the conduction of impulses along nerve fibers. Changes the action potential in membranes nerve cells without a pronounced effect on the resting potential. Suppresses the conduction of not only pain, but also impulses of other modalities. With absorption and direct intravascular administration, it reduces the excitability of peripheral cholinergic receptors, reduces the formation and release of acetylcholine from preganglionic endings (it has some ganglion-blocking effect), eliminates spasm of smooth muscles, and reduces the excitability of the myocardium and motor areas of the cerebral cortex. When administered intravenously, it has analgesic, hypotensive and antiarrhythmic action(increases the effective refractory period, reduces excitability, automatism and conduction), in large doses can disrupt neuromuscular conductivity. Eliminates the descending inhibitory influences of the reticular formation of the brain stem. Inhibits polysynaptic reflexes. In high doses, it can cause convulsions. It has a short anesthetic activity (duration infiltration anesthesia is 0.5-1h).

Pharmacokinetics
Undergoes complete systemic absorption. The degree of absorption depends on the site (the degree of vascularization and the rate of blood flow in the injection site), the route of administration and the total dosage. It is rapidly hydrolyzed by plasma and liver esterases with the formation of 2 main pharmacologically active metabolites: diethylaminoetonol (has a moderate vasodilating action) and para-aminobenzoic acid (it is a competitive antagonist of sulfanilamide chemotherapy drugs and can weaken their antimicrobial effect). The half-life is 30-50 seconds, in the neonotal period -54-114 s. It is excreted mainly by the kidneys in the form of metabolites, no more than 2% is excreted unchanged.

Indications for use

• infiltration, conduction and epidural anesthesia;
• vagosympathetic cervical, pararenal, circular and paravertebral blockades.

Contraindications
Hypersensitivity (including to para-aminobenzoic acid and other local anesthetics), childhood up to 12 years old.
For anesthesia by the method of creeping infiltrate: pronounced fibrotic changes in tissues. For epidural anesthesia: atrioventricular block, marked decrease in blood pressure, shock, infection of the lumbar puncture site, septicemia.

Carefully
emergency operations, accompanied acute blood loss; conditions accompanied by a decrease in hepatic blood flow (for example, in chronic heart failure, liver diseases); pseudocholinesterase deficiency; kidney failure; children's age from 12 to 18 years and in elderly patients (over 65 years); weakened patients; pregnancy and childbirth.

Dosage and administration
For infiltration anesthesia: use 0.25-0.5% solutions; for anesthesia according to the Vishnevsky method (tight creeping infiltration) - 0.125-0.25% solutions. To reduce absorption and prolong the action during local anesthesia, an additional 0.1% solution of epinephrine hydrochloride is administered - 1 drop per 2-5-10 ml of procaine solution. Higher doses for infiltration anesthesia for adults: first single dose at the beginning of the operation - no more than 500 ml for a 0.25% solution or 150 ml for a 0.5% solution. In the future, during each hour of the operation - no more than 1000 ml for a 0.25% solution or 400 ml for a 0.5% solution.
Maximum dose for use in children over 12 years of age -15 mg / kg.
For conduction anesthesia: 1-2% solutions (up to 25 ml); for epidural - 2% solution (20-25 ml). With pararenal blockade (according to A.V. Vishnevsky), 50-80 ml of a 0.5% solution or 100-150 ml of a 0.25% solution are injected into the perirenal tissue, and with vagosympathetic blockade - 30-100 ml of a 0.25% solution.
For circular or paravertebral blockades, a 0.25% - 0.5% solution is injected intradermally.

Side effect
Headache, dizziness, drowsiness, weakness, cauda equina syndrome, convulsions, increased or decreased blood pressure, collapse, peripheral vasodilation, bradycardia, arrhythmia, pain in chest, involuntary urination or defecation, impotence, methemoglobinemia, allergic reactions (up to anaphylactic shock).
From the side digestive system: nausea, vomiting.
Other: return of pain, persistent anesthesia, hypothermia, with anesthesia in dentistry: numbness and paresthesia of the lips and tongue, prolongation of anesthesia.

Overdose
Symptoms: pallor skin and mucous membranes. Dizziness, nausea, vomiting, "cold" sweat, increased severity of side effects. Treatment: maintaining adequate pulmonary ventilation, detoxification and sympathetic therapy.

Interaction
Enhances the inhibitory effect on the central nervous system of means for general anesthesia, sleeping pills and sedatives, narcotic analgesics and tranquilizers.
The risk of sharp decline blood pressure and bradycardia.
Anticoagulants (ardeparin, dalteparin, danaparoid, enoxaparin, heparin, warfarin) increase the risk of bleeding. When treating the injection site local anesthetic disinfectant solutions containing heavy metals increases the risk of developing local reaction in the form of pain and swelling.
Use with MAO inhibitors (furazolidone, procarbazine, selegeline) increases the risk of hypotension.
Strengthen and lengthen the action of muscle relaxants.
When prescribing procaine together with narcotic analgesics, an additive effect is noted, which is used during spinal and epidural anesthesia, while respiratory depression increases.
Vasoconstrictors (epinephrine, methoxamine, phenylephrine) prolong the local anesthetic effect.
Procaine reduces the antimyasthenic effect of drugs, especially when used in high doses, which requires additional correction in the treatment of myasthenia gravis.
Cholinesterase inhibitors (anti-myasthenic JIC, cyclophosphamide, demecarine, ecothiophate, thiotepa) reduce the metabolism of procaine.
The procaine metabolite (para-aminobenzoic acid) is a sulfonamide antagonist.

special instructions
Patients require control of the functions of the cardiovascular, respiratory and central nervous systems. It is necessary to cancel MAO inhibitors 10 days before the introduction of a local anesthetic. During the period of treatment, it is necessary to refrain from driving vehicles and engaging in potentially dangerous species activities requiring increased concentration attention and speed of psychomotor reactions. Before use, mandatory testing for individual sensitivity to the drug. It should be borne in mind that when conducting local anesthesia using the same total dose, the toxicity of novocaine is the higher, the more concentrated solution used. Not absorbed from mucous membranes; does not provide surface anesthesia for skin application.

Release form:

Storage conditions
List B. In a dark place.

Best before date
3 years. Do not use after the expiry date stated on the package.

Terms of dispensing from pharmacies
Released by prescription.

Manufacturer / Organization accepting claims:
FSUE "Armavir Biological Factory"
352212. Russia, Krasnodar Territory, Novokubansky district, Progress settlement, st. Mechnikova, 11

local anesthetic

Active substance

Procaine (procaine)

Release form, composition and packaging

Solution for injection 0.5% transparent, colorless.

Excipients: hydrochloric acid 0.1M, water for injection.

2 ml - ampoules (10) / complete with an ampoule knife or a scarifier, if necessary for ampoules of this type /) - packs of cardboard.
5 ml - ampoules (10) / complete with an ampoule knife or a scarifier, if necessary for ampoules of this type /) - packs of cardboard.
10 ml - ampoules (10) / complete with an ampoule knife or a scarifier, if necessary for ampoules of this type /) - packs of cardboard.

pharmachologic effect

A local anesthetic with moderate anesthetic activity and a wide range of therapeutic effects. Being a weak base, it blocks Na + - channels, prevents the generation of impulses at the endings of sensory nerves and the conduction of impulses along nerve fibers. Changes the action potential in the membranes of nerve cells without a pronounced effect on the resting potential. Suppresses the conduction of not only pain, but also impulses of a different modality. With absorption and direct vascular injection into the bloodstream, it reduces the excitability of peripheral cholinergic systems, reduces the formation and release of acetylcholine from preganglionic endings (it has some ganglion-blocking effect), eliminates spasm of smooth muscles, and reduces the excitability of the myocardium and motor areas of the cerebral cortex. Eliminates the descending inhibitory influences of the reticular formation of the brain stem. Inhibits polysynaptic reflexes. In high doses, it can cause convulsions. It has a short anesthetic activity (the duration of infiltration anesthesia is 0.5-1 h).

Pharmacokinetics

Undergoes complete systemic absorption. The degree of absorption depends on the site and route of administration (especially on vascularization and blood flow rate of administration) and the final dose (amount and concentration). It is rapidly hydrolyzed by esterases and the liver to form two main pharmacologically active metabolites: diethylaminoethanol (has a moderate vasodilating effect) and para-aminobenzoic acid (is a competitive antagonist sulfa drugs and may weaken their effect). T 1/2 - 30-50 s, in the neonatal period - 54-114 s. It is excreted mainly by the kidneys in the form of metabolites, no more than 2% is excreted unchanged.

Indications

Infiltration (including intraosseous) anesthesia; vagosympathetic cervical, pararenal, circular and paravertebral blockades.

Contraindications

Hypersensitivity (including to para-aminobenzoic acid and other local anesthetic esters). Children's age up to 12 years.

For anesthesia by the method of creeping infiltrate - pronounced fibrous changes in the tissues.

Carefully. Emergency operations accompanied by acute blood loss; conditions accompanied by a decrease in hepatic blood flow (for example, chronic insufficiency, liver disease); progression cardiovascular insufficiency(usually due to the development of heart blocks and shock); inflammatory diseases or infection at the injection site; pseudocholinesterase deficiency; ; children's age from 12 to 18 years, elderly age(over 65 years old); with caution in seriously ill and / or debilitated patients; during pregnancy and during childbirth.

Dosage

Only for procaine solution 5 mg/ml (0.5%).

For infiltration anesthesia 350-600 mg (70-120 ml) are administered. Higher doses for infiltration anesthesia for adults: the first single dose at the beginning of the operation - not more than 0.75 g (150 ml), then during each hour of the operation - not more than 2 g (400 ml) of the solution.

At pararenal blockade(according to A.V. Vishnevsky) 50-80 ml is injected into the perirenal tissue.

At circular and paravertebral blockade intradermally injected 5-10 ml. With vagosympathetic blockade, 30-40 ml is administered.

For reduce absorption and prolong action with local anesthesia, additionally injected 0.1% solution of epinephrine hydrochloride - 1 drop per 2-5-10 ml of procaine solution.

The maximum dose for use in children over 12 years old- 15 mg/kg.

Side effects

From the side of the central and peripheral nervous system: headache, dizziness, drowsiness, weakness, lockjaw.

From the side of the cardiovascular system: increase or decrease in blood pressure, peripheral vasodilation, collapse, bradycardia, arrhythmias,.

From the side of the hematopoietic organs: methemoglobinemia.

Allergic reactions: skin itching, skin rash, others anaphylactic reactions(including anaphylactic shock), urticaria (on the skin and mucous membranes). If any of the side effects indicated in the instructions appeared during the use of the drug or they are aggravated, or you notice any other side effects not indicated in the instructions, tell your doctor about it.

Overdose

Symptoms: pallor of the skin and mucous membranes, dizziness, nausea, vomiting, "cold" sweat, increased respiration, tachycardia, lowering blood pressure, up to collapse, apnea, methemoglobinemia. The action on the central nervous system is manifested by a feeling of fear, hallucinations, convulsions, motor excitation.

Treatment: maintaining adequate pulmonary ventilation, detoxification and symptomatic therapy.

drug interaction

Enhances the inhibitory effect on the central nervous system of drugs for general anesthesia, hypnotics, sedatives, narcotic analgesics and tranquilizers.

Anticoagulants (sodium ardeparin, sodium dalteparin, sodium danaparoid, sodium heparin, warfarin) increase the risk of bleeding. When treating the injection site with disinfectant solutions containing heavy metals, the risk of developing a local reaction in the form of pain and swelling increases.

Use with monoamine oxidase inhibitors (, procarbazine, selegiline) increases the risk of developing a pronounced decrease in blood pressure. Enhances and prolongs the action of muscle relaxant drugs. Vasoconstrictors (epinephrine, methoxamine, phenylephrine) prolong the local anesthetic effect.

Procaine reduces the antimyasthenic effect of drugs, especially when used in high doses, which requires additional correction in the treatment of myasthenia gravis.

Cholinesterase inhibitors (antimyasthenic drugs, cyclophosphamide, demecarium bromide, ecothiopa iodide, thiotepa) reduce the metabolism of local anesthetic drugs.

The metabolite of procaine (para-aminobenzoic acid) is a sulfonamide antagonist.

special instructions

Patients require monitoring of the functions of the cardiovascular system, respiratory system and the central nervous system.

It is necessary to cancel monoamine oxidase inhibitors 10 days before the introduction of a local anesthetic.

It should be borne in mind that when performing local anesthesia using the same total dose, the toxicity of procaine is the higher, the more concentrated the solution is used.

Impact on ability to drive vehicles and mechanisms

During the period of treatment, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require an increased concentration of attention and speed of psychomotor reactions.

Pregnancy and lactation

If it is necessary to prescribe the drug during pregnancy, the expected benefit to the mother and potential risk for the fetus. With caution during childbirth.

If necessary, the use of the drug during lactation should decide on the termination of breastfeeding.

Terms of dispensing from pharmacies

The drug is dispensed by prescription.

Terms and conditions of storage

Store the drug in a place protected from light, at a temperature not exceeding 25°C. Keep out of the reach of children.

Shelf life - 3 years. Do not use after the expiry date stated on the package.