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NERVOUS SYSTEM › ANESTHETICS › ANESTHETICS, LOCAL › Esters of aminobenzoic acid
chloroprocaine
N01BA04
Forms & Strengths
- Injectable solution: 2% (20 mg/mL)
- Injectable solution: 3% (30 mg/mL)
- Injectable solution with epinephrine 1:200,000: 2%
- Injectable solution with epinephrine 1:200,000: 3%
Adult Dosing
- Infiltration and peripheral nerve block: 1% to 2% solution, max 800 mg (or 11 mg/kg) without epinephrine; up to 1000 mg (or 14 mg/kg) with epinephrine
- Epidural block: 2% or 3% solution, 15 to 25 mL (300 to 750 mg)
- Caudal block: 2% solution, 15 to 25 mL (300 to 500 mg)
Pediatric Dosing
- Caudo-epidural block (neonates and infants): 2% or 3% solution, 0.5 to 1.0 mL/kg
- Safety and efficacy in children under 3 years for procedures other than caudal/epidural block are not well established
Indications
- Production of local anesthesia by infiltration
- Peripheral nerve block
- Central neural block (epidural and caudal blocks)
- Particularly indicated for obstetric anesthesia due to rapid onset and short duration
Mechanism of Action
- Esters-type local anesthetic
- Reversibly blocks nerve conduction by decreasing the influx of sodium ions through nerve membrane ion channels
- Stabilizes neuronal membranes and prevents depolarization and propagation of the action potential
Contraindications
- Hypersensitivity to local anesthetics of the ester type, para-aminobenzoic acid (PABA), or its derivatives
- Obstetric paracervical block (associated with high fetal mortality due to bradycardia and acidosis)
- Intravenous regional anesthesia (Bier block)
- Severe central nervous system depression or uncorrected hypotension
Adverse Reactions
- Central nervous system: Lightheadedness, dizziness, nervousness, apprehension, euphoria, confusion, drowsiness, convulsions, CNS depression
- Cardiovascular system: Hypotension, myocardial depression, bradycardia, cardiac arrest
- Allergic: Urticaria, pruritus, erythema, angioedema, anaphylactoid reactions (due to PABA metabolite)
- Neurologic: Prolonged neural blockade, arachnoiditis, spinal-related complications (with accidental intrathecal high-dose administration)
Drug Interactions
- Class III antiarrhythmic drugs (e.g., amiodarone): Cardiac effects may be additive
- Other local anesthetics: Toxic effects are additive
- Cholinesterase inhibitors: May impair the metabolism of chloroprocaine, increasing risk of systemic toxicity
- Non-depolarizing muscle relaxants: Effects may be potentiated by local anesthetics
Curated Content: Needs Vetting Before Put to Clinical Use