prilocaine

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Related to Citanest: prilocaine, Articaine

prilocaine

 [pril´o-kān]
a local anesthetic, used parenterally as the hydrochloride salt or topically, together with lidocaine, as the base.

prilocaine

/pril·o·caine/ (pril´o-kān) a local anesthetic, used parenterally as the hydrochloride salt or topically, together with lidocaine, as the base.

prilocaine

(prĭl′ō-kān′)
n.
A local anesthetic, C13H20N2O, used parenterally in its hydrochloride form for nerve blocks and in combination with lidocaine for topical use.

prilocaine

A local anaesthetic drug normally given by injection. A brand name is Citanest. The drug can also be applied in a cream for surface anaesthesia under the brand name EMLA.

prilocaine

; Citanest relatively short- to moderate-acting local anaesthetic agent of low systemic toxicity, similar to but less vasodilatory than lidocaine; maximum safe dose = 400mg for a 70-kg adult; should not be used on pregnant/lactating women as its metabolites can cause fetal/infant methaemoglobinaemia; avoid use on patients with severe/untreated hypertension or severe heart disease; dosage should be reduced for elderly or debilitated patients, or those with hepatic or renal impairment; high strengths may cause ocular toxicity (see local anaesthetic (LA) administration, pregnancy; Table 1 and Table 2)
Table 1: Maximum safe doses of plain local anaesthetic agents (for 70Kg adult in 24 hours)
Agent (brand name)Maximum safe dose (70-kg adult)Dose per kg of body mass
Lidocaine (Xylocaine)200mg3mg/kg
Bupivacaine (Marcain)150mg2mg/kg
Levo-bupivacaine (Chirocaine)150mg2mg/kg
Mepivacaine (Scandonest)400mg6mg/kg
Prilocaine (Citanest)400mg6mg/kg
Ropivacaine (Naropin)250mg3.5mg/kg
Table 2: Calculation of the combined maximum safe doses (MSDs) of plain local anaesthetic agents
Mass of drug administeredAmount of drugs administered in relation to proportional MSDsPercentage of combined MSD
e.g. 70-kg adult
Agent 1
6mL lidocaine 2%
120mgEquivalent to (120/200) × 100% = 60% of MSD lidocaine77%
Agent 2
5mL bupivacaine 0.5%
25mgEquivalent to (25/150) × 100% = 17% of MSD bupivacaine
e.g. 40-kg child
Agent 1
4mL lidocaine 2%
80mgEquivalent to (80/120) × 100% = 77% of MSD lidocaine89.5%
Agent 2
2mL bupivacaine 0.5%
10mgEquivalent to (10/80) × 100% = 12.5% of MSD bupivacaine

Where more than one anaesthetic agent is injected in order to achieve both rapid anaesthesia and prolonged postoperative pain relief, the proportional MSD of each of the anaesthetic agents should be calculated, in order not to exceed the combined MSD.

The calculation is the product of the patient's body mass, the percentage mass of the individual anaesthetic agent and the total volume used of each local anaesthetic drug.

In the examples cited in this table, safe doses of anaesthesia would have been administered, as the combined doses of each anaesthetic does not exceed 100%.

prilocaine

a local anesthetic, used as the hydrochloride salt.