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Novocaine Intraspinal (Procaine Hydrochloride Intraspinal) - Warnings and Precautions

 
 



WARNINGS

RESUSCITATIVE EQUIPMENT AND DRUGS SHOULD BE IMMEDIATELY AVAILABLE WHENEVER ANY LOCAL ANESTHETIC DRUG IS USED. Spinal anesthesia should only be administered by those qualified to do so.

Large doses of local anesthetics should not be used in patients with heartblock.

Reactions resulting in fatality have occurred on rare occasions with the use of local anesthetics, even in the absence of a history of hypersensitivity.

Usage in Pregnancy. Safe use of NOVOCAIN has not been established with respect to adverse effects on fetal development. Careful consideration should be given to this fact before administering this drug to women of childbearing potential particularly during early pregnancy. This does not exclude the use of the drug at term for obstetrical analgesia. Vasopressor agents (administered for the treatment of hypotension or added to the anesthetic solution for vasoconstriction) should be used with extreme caution in the presence of oxytocic drugs as they may produce severe, persistent hypertension with possible rupture of a cerebral blood vessel.

Solutions which contain a vasoconstrictor should be used with extreme caution in patients receiving drugs known to produce alterations in blood pressure (i.e., monoamine oxidase inhibitors (MAOI), tricyclic antidepressants, phenothiazines, etc.), as either severe sustained hypertension or hypotension may occur.

Local anesthetic procedures should be used with caution when there is inflammation and/or sepsis in the region of the proposed injection.

Contains acetone sodium bisulfite, a sulfite that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people.

PRECAUTIONS

Standard textbooks should be consulted for specific techniques and precautions for various spinal anesthetic procedures.

The safety and effectiveness of a spinal anesthetic depend upon proper dosage, correct technique, adequate precautions, and readiness for emergencies. The lowest dosage that results in effective anesthesia should be used to avoid high plasma levels and possible adverse effects. Tolerance varies with the status of the patient. Debilitated, elderly patients, or acutely ill patients should be given reduced doses commensurate with their weight and physical status. Reduced dosages are also indicated for obstetric delivery and patients with increased intra-abdominal pressure.

The decision whether or not to use spinal anesthesia in the following disease states depends on the physician’s appraisal of the advantages as opposed to the risk: cardiovascular disease (i.e., shock, hypertension, anemia, etc.), pulmonary disease, renal impairment, metabolic or endocrine disorders, gastrointestinal disorders (i.e., intestinal obstruction, peritonitis, etc.), or complicated obstetrical deliveries.

NOVOCAIN SHOULD BE USED WITH CAUTION IN PATIENTS WITH KNOWN DRUG ALLERGIES AND SENSITIVITIES. A thorough history of the patient’s prior experience with NOVOCAIN or other local anesthetics as well as concomitant or recent drug use should be taken (see CONTRAINDICATIONS). NOVOCAIN should not be used in any condition in which a sulfonamide drug is being employed since aminobenzoic acid inhibits the action of sulfonamides.

Solutions containing a vasopressor should be used with caution in the presence of diseases which may adversely affect the cardiovascular system.

NOVOCAIN should be used with caution in patients with severe disturbances of cardiac rhythm, shock or heartblock.

Page last updated: 2007-08-28

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