Lidociane, Bupivacaine and Procain

Lidociane

Its potency and duration of action are both in the middle.

Mechanism of Action

• By attaching to certain receptors on the inner protein of the channel, block Na+ channels.
• It interacts with a receptor located within voltage-sensitive Na+ channels and raises the threshold of channel opening, causing impaired ion influx that prevents depolarization and prevents the generation of action potentials. When the threshold potential falls to a high value, conduction block occurs.

Indication

• Epidural & spinal anesthesia, nerve block, surface application, infiltration, and nerve block

Dose

• Maximum doses without adrenaline are 3 mg/kg and with it, 7 mg/kn.
• It contains adrenaline or a note and is dose-adjusted in accordance with the surgical site and the patient's response under close observation.
• Lidocaine injection, 1%–2%
• Localized infiltration and nerve block:
• Anesthesia for infiltration: up to 3 mg/kg
• For procedures on the lower limbs, pelvis, lower abdomen, prostatectomy, obstetric procedure, cesarean section, etc., spinal anesthesia is employed.
• A 40-kg patient can receive up to 3 mg/kg of 1% lumbar epidural analgesia and up to 3 mg/kg of 2% lumbar epidural anesthesia. Maximum dose: 3 mg/kg (apart from spinal anesthesia).
• 2% lidocaine and 1:200,000 epinephrine
• maximum dose of 7mg (equal to 0.35ml 2%)/kg or 500mg for infiltration anesthesia
• (in glucose 7.5%) Lidocaine 5% heavy for spinal usage
• Spinal sedation: 75–100 mg
• Topical 4% lidocaine solution
• Before bronchoscopy, esophagoscopy, indotrachial intubation, and biopsy in the mouth and throat, the membranes of the throat, GIT, and 40-300mg (1-7.5ml) of surface anesthesia. dosage maximum of 2.4 grams.
• Lidocaine topical jelly 2%
• The urinary tract is sedated:
  • Female: 100–200 mg injected several minutes before inspection into urethra
  • Male: Two injections totaling 400 mg.

Contraindications

• AV block, hypersensivity, conduction distrubance, cardiac compensation

Side Effect

• Vasodilation on the injected area, sleepiness, mental fogginess, altered taste, tinnitus, lightheadedness, dizziness, bradycardia, mental confusion, muscle twitching convulsions, cardiac arrhythmia, hypotension, and respiratory arrest are some of the side effects that may occur.

Bupivacaine

Its activity lasts a very long time and is highly potent.

Mechanism of Action

• By attaching to certain receptors on the inner protein of the channel, block Na+ channels.
• It interacts with a receptor located within voltage-sensitive Na+ channels and raises the threshold of channel opening, causing impaired ion influx that prevents depolarization and prevents the generation of action potentials. When the threshold potential falls to a high value, conduction block occurs.

Indication

• Localized intrusion
• Block of peripheral nerves
• A spinal blockade spinal sedation
• Blocked brachial plexus
• Surgical aftercare and chronic pain management

Dose

• Spinal anesthesia: 20-40mg (2-4ml)
• Epidural block, surgery, lumbar: max 30ml

Contraindication

• Hypersensivity, myasthenia gravis, spinal or epidural anesthesia in dehydrated or hypovolemic patients, intravenous regional anesthesia, adjacent skin infection or inflammation, severe anemia, and cardiac disease are contraindicated.

Side Effect

• Shivering, twitching, dizziness, tremors, convulsions, respiratory arrest, cardiac depression, bradycardia, hypotension, cardiac arrhythmia, vascular collapse, delayed wound healing, and allergic reaction are some of the symptoms of hypotension.

Nursing Consideration

• Dental procedures can benefit from bupivacaine.
• The spinal anesthetic bupivacaine is frequently used for C/S procedures.
• Bupivacaine heavy can occasionally cause hypersensitivity, which can have an impact on multiple organ systems (failure)
• Bupivacaine comes in a variety of forms, thus nurses are advised to read the labels on the containers as well.
• The preferred Bupivacaine is branded.
• Inform doctors and pharmacists right away if there are any negative effects so that they can document them.

Procain

Its activity lasts only briefly and has minimal potency.

Mechanism of Action

• It primarily affects peripheral neurons by preventing sodium inflow through voltage-gated sodium channels in the neuronal cell membrane.

Indication

• These are utilized to create local and regional anesthesia. It is primarily utilized for peripheral nerve block and infiltration anesthesia.

Dose

• Procaine 1% Injectable Solution
• Procaine 10% Injectable Solution
• Procaine 2% Injectable Solution

Contraindication

• Impairment of the liver, heart, issues with blood clotting or bleeding, and myasthenia gravis.

Side Effect

• A sensitivity response (difficulty breathing, closing of the throat, swelling of the lips, tongue, or face or hives) tingling, numbness, slow or irregular heartbeats, chest pain, dizziness or sleepiness, anxiety, nausea or vomiting.

Nursing Cofisideration

• Dental procedures benefit from using procaine.
• The spinal anesthetic procaine is frequently used for C/S procedures.
• Procaine heavy can [rarely] display hypersensitivity; if it does, it can impact multiple organs (failure)
• Because there are numerous varieties of procaine, nurses are advised to read the labels on the containers as well.
• The recommended procaine is branded.
• Inform doctors and pharmacists right away if there are any negative effects so that they can document them.