94
E. ANESTHETIC AGENTS
(1) Topical Anestheticsc
Drug |
Trade |
Preparation |
Dose |
Notes |
benoxinate |
Fluress, Fluorox |
Soln, 0.4% with 0.25% |
1 drop |
Duration 15–30 min, Ester |
|
|
fluorescein sodium |
|
linkage, preserved with |
|
|
|
|
chlorobutanol |
cocaine |
N/A |
Soln, 1%–4% |
1 drop |
Duration 20–45 min, pupillary |
hydrochloride |
|
|
|
dilation, potentiates |
|
|
|
|
epinephrine |
paracaine |
OCuSOFT |
Soln, 0.5% |
1 drop |
|
proparacaine |
AK-Taine, Alcaine, Ocu-Caine, |
Soln, 0.5% |
1 drop |
Duration 15–30 min. |
|
Ophthaine, Ophthetic |
|
|
Ester linkage, Ophthetic |
|
|
|
|
preserved with benzalkonium |
|
|
|
|
chloride |
|
Fluorocaine |
Soln, 0.5% with 0.25% |
1 drop |
|
|
|
fluorescein sodium |
|
|
tetracaine |
AK-T-Caine, Pontocaine |
Soln, 0.5% |
1 drop |
Duration 9–24 min. |
|
|
|
|
Ester linkage |
|
|
|
|
|
Notes: 1) Topical anesthetics should only be used to allow the clinician to perform ocular procedures. They are not indicated for use by the patient and should never be prescribed.
2)Allergies to topical anesthetic drops may be a reaction to the medication itself, class of linkage (e.g. amide versus ester), or simply the preservative.
(2) Local Anestheticsc (To convert percent solutions to mg/ml, multiply by 10; e.g. 1% = 10 mg/ml)
Drug |
Trade |
Preparation |
Maximum Adult Dose |
Duration of Action |
Pain on Injectionx |
Linkage1 |
|
bupivacaine |
Marcaine, |
Soln, 0.25–0.75% |
23 ml of 0.75% soln |
3 to 12 hrs |
|
5 |
Amide |
|
Sensorcaine |
|
|
|
|
|
|
chloroprocaine |
Nesacaine |
Soln, 1–3% |
40 ml of 2% soln |
60 min |
|
N/A |
Ester |
etidocaine |
Duranest |
Soln 1% |
40 ml of 1% soln |
5–10 hrs |
|
N/A |
Amide |
hexylcaine |
|
Soln, 1–2% |
|
60 min |
|
N/A |
Ester |
lidocaine |
Xylocaine |
|
|
|
|
|
Amide |
Without epinephrine |
Soln, 1–2% |
15 ml of 2% soln |
60 to 75 min. |
1 |
|
||
With epinephrine |
Soln, 1–2% |
25 ml of 2% soln |
2 hrs. |
2 |
|
||
mepivacaine |
Carbocaine |
Soln, 1–2% |
15 ml of 2% soln |
2 to 3 hrs |
4 |
Amide |
|
procaine |
Novocaine |
Soln, 1–4% |
38 ml of 2% soln |
30 to 45 min. |
3 |
Ester |
|
|
|
|
|
|
|
|
|
(3) Adjunctsc
Drug |
Trade |
Preparation |
Usual Dose |
Notes |
hyaluronidase |
Vitrase |
200 USP units/ml |
50–300 units, typical dose 150 |
Depolymerizes polysaccharides and increases |
|
|
|
USP units |
effective area of anesthesia, decreases |
|
|
|
|
duration of local anesthesia |
|
|
Lyophilized, 6200 Reconstitute to 1000 USP |
Depolymerizes polysaccharides and increases |
|
|
|
USP units |
units/vial by adding 6.2 ml of |
effective area of anesthesia, decreases |
|
|
|
solution to the vial. Common |
duration of local anesthesia |
|
|
|
dose is 150 USP units |
|
sodium bicarbonate |
|
1 mEq/ml |
1 ml in 10 ml anesthetic |
Decreases pain on injection |
|
|
|
|
|
Miscellaneous 95