Prilocaine

Prilocaine (Citanest)

Category:

Local anesthetic

Description:

Local amide anesthetic

Indications:

Dental anesthesia
Infiltration anesthesia
Peripheral nerve block
Local anesthesia

Contraindications:

Anticoagulant therapy, amide local anesthetic hypersensitivity, coagulopathy
Intraarterial/intravenous administration, infection, thrombocytopenia

Precautions:

Pregnancy category B; avoid breastfeeding
Cardiac disease, AV block, elderly, hepatic disease
Head and neck anesthesia, myasthenia gravis
Shock, methemoglobinemia

Adverse Reactions (Side Effects):

anaphylactoid reactions, anxiety, atrial fibibrillation, AV block, cardiac arrest
blurred vision, dizziness, drowsiness, nausea, vomiting, PR and QT prolongation
Pruritis, rash, restlessness, respiratory depression, tremor, urticaria
Sinus bradycardia, sinus tachycardia

Dosage:

Administered by infiltration or by peripheral block techniques

Dental anesthesia via infiltration and local anesthesia via peripheral nerve block:
- Note: Individual variations in onset and duration may occur
- Regional dosage:
  - Adult: Initially, 1-2 ml (40-80mg) of a 4% solution injected SQ
  - Child <10 years: Inject not more than 1ml (40mg) of a 4% solution SC
  - Corresponding doses for younger children may be determined by Clark’s rule (wt in pounds X adult dose)/150
Maximum Dosage:
- Adult:
  - 600 mg/dose (8 mg/kg/dose) and no more than 600mg should be administered in any 2 hour period
- Child 11-12 years:
  - Max dose info not available
- Child < 10 years:
  - 40 mg/dose

Source: Operational Medicine 2001, Health Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington, D.C., 20372-5300