普魯卡因與腎上腺素
Procaine with Epinephrine
Procaine hydrochloride with epinephrine bitartrate
別名: Willcain · Procaine adrenaline · Novocain with epinephrine
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
各物種劑量
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概覽
普魯卡因是一種短效酯類局部麻醉劑。添加腎上腺素作為血管收縮劑，以延長作用時間並減少全身吸收率，從而降低全身毒性的風險。
臨床提示： 普魯卡因在血漿中被假性膽鹼酯酶迅速水解，因此相對安全，但若不添加腎上腺素則作用時間極短。主要用於局部浸潤和神經阻滯。
作用機制
Procaine causes a reversible blockade of the voltage-gated sodium channels → prevents the influx of sodium → inhibits the propagation of action potentials along the nerve fiber. Sensory nerve fibers are blocked before motor nerve fibers, allowing a selective sensory blockade at low doses.
Epinephrine stimulates alpha-1 adrenergic receptors → local vasoconstriction → delays systemic absorption of procaine, increasing its local duration of action.
安全性與警告
禁忌症
- Intravenous administration
- Use in areas supplied by end-arteries (e.g., tail, ears, digits) due to risk of ischemic necrosis
- Known hypersensitivity to ester-type local anesthetics or PABA
- Epidural use (depending on specific formulation preservatives)
不良反應
- Local tissue irritation
- Ischemia or tissue necrosis (due to epinephrine)
- CNS excitation followed by depression (at toxic doses)
- Cardiovascular depression, hypotension, or arrhythmias (at toxic doses)
- Allergic reactions (ester anesthetics are metabolized to PABA, a known allergen)
注意事項
WARNING: Do not use epinephrine-containing solutions in extremities or areas with collateral-poor circulation (e.g., tail, ears, digits) due to the risk of severe ischemia and tissue sloughing.
Always aspirate the syringe before injecting to ensure the needle is not in a blood vessel, as accidental intravenous injection can cause severe cardiovascular and CNS toxicity.
藥物相互作用
Procaine is metabolized to PABA, which competitively antagonizes the antibacterial effect of sulfonamides.
May antagonize the vasoconstrictive effects of epinephrine.
Sensitizes the myocardium to catecholamines; increased risk of arrhythmias with epinephrine.
監測
- Heart rate and rhythm
- Blood pressure
- Signs of CNS toxicity (tremors, seizures)
- Tissue perfusion at the injection site
藥物動力學
半衰期
吸收
Systemic absorption is significantly delayed by the vasoconstrictive action of epinephrine.
分佈
Distributes locally at the injection site; systemic distribution is minimal unless accidentally injected IV or given in large volumes.
代謝
Procaine is rapidly hydrolyzed by plasma pseudocholinesterases to para-aminobenzoic acid (PABA) and diethylaminoethanol. Epinephrine is metabolized by COMT and MAO in the liver and tissues.
排除
Metabolites are primarily excreted in the urine.
過量
Overdose or accidental IV injection can lead to systemic toxicity.
- CNS signs: Restlessness, tremors, seizures, followed by severe CNS depression.
- Cardiovascular signs: Arrhythmias, hypotension, and cardiovascular collapse.
- Treatment: Supportive care, oxygen therapy, control seizures with diazepam or midazolam, and manage arrhythmias. Intravenous lipid emulsion (ILE) therapy may be considered for severe local anesthetic systemic toxicity (LAST).
可用產品
劑型
- Solution for injection
獸醫用
- Willcain Solution for injection
各地核准狀態
Approved in various member states under different trade names.
Willcain is classified as POM-VPS in the UK.
暫無法規資料: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store at room temperature. Protect from light, as epinephrine is light-sensitive and can oxidize (solution will turn pink or brown if oxidized and should be discarded).
飼主須知
您的寵物已接受局部麻醉以使特定區域麻木以便進行手術。
重要提示： 該區域可能會麻木數小時。請防止您的寵物咀嚼、抓撓或摩擦麻木區域，因為牠們可能會在沒有感覺的情況下造成嚴重的自我傷害。
請觀察注射部位是否有過度腫脹、發紅或皮膚變色的跡象，如果您發現任何異常行為，請聯繫您的獸醫。
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