丙美卡因 / 普羅帕卡因
Proxymetacaine
Proxymetacaine hydrochloride
別名: Alcaine · Minims Proxymetacaine · Ophthaine · Proxymetacaine hydrochloride · Proparacaine hydrochloride
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
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Ocular surface anaesthesia | 1-2 drops/eye | topical | PRN | Single application (or serial for depth) | 🌍 EU |
| Aural/nasal anaesthesia | 5-10 drops/ear or nose | topical | q5-10min | Maximum 3 doses if used intranasally | 🌍 EU |
- Ocular surface anaesthesia: Maximal effect at 15 min, duration 45-55 min.
貓
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Ocular surface anaesthesia | 1-2 drops/eye | topical | PRN | Single application | 🌍 EU |
- Ocular surface anaesthesia: Maximal effect at 15 min, duration 25 min.
劑量為合格獸醫專業人員的臨床參考。請務必對照最新仿單及個別病患確認。
概覽
丙美卡因（又稱普羅帕卡因）是一種快速起效的局部麻醉劑，主要用於眼球表面（角膜和結膜囊）、外耳道和鼻腔。它能迅速起效（1分鐘內），並根據物種不同提供25-55分鐘的麻醉效果。
臨床警告： 所有局部麻醉劑對角膜上皮均有毒性。反覆使用會延遲潰瘍癒合，並可能導致嚴重的角膜溶解。絕對不能作為居家止痛藥物開立給畜主。
臨床提示： 連續點藥可增加麻醉的持續時間和深度。由於局部麻醉劑會阻斷反射性淚液分泌，因此不應在進行淚液測試（Schirmer tear test）之前使用。
作用機轉
Local anaesthetic action is dependent on the reversible blockade of voltage-gated sodium channels → prevents the influx of sodium ions → inhibits the propagation of an action potential along the nerve fibre.
Sensory nerve fibres are blocked before motor nerve fibres, allowing a selective sensory blockade at low doses.
安全性與警告
禁忌症
- Therapeutic use (e.g., home pain management)
- Application prior to a Schirmer tear test
不良反應
- Conjunctival hyperaemia (common)
- Local irritation / chemosis (occasional)
- Corneal epithelial toxicity
- Delayed corneal ulcer healing
注意事項
Corneal Toxicity: Repeated use causes severe epithelial toxicity and delays ulcer healing. Must only be used for diagnostic or minor surgical procedures in a clinical setting. Diagnostic Interference: Do not use before a Schirmer tear test as it abolishes reflex tearing.
監測
- Corneal integrity (fluorescein staining if damage is suspected)
- Resolution of anaesthesia (protect the eye from trauma while numb)
藥物動力學
吸收
Rapid onset (< 1 minute) following topical application to mucous membranes.
分佈
Acts locally at the site of application (cornea, conjunctiva, nasal mucosa, ear canal).
代謝
Ester-type local anaesthetics are generally hydrolyzed by plasma pseudocholinesterases and esterases in the tissue.
排除
Metabolites are primarily excreted via the kidneys.
過量
Overdosage via repeated topical application leads to severe corneal toxicity, epithelial sloughing, delayed healing of ulcers, and potentially corneal melting. Systemic toxicity is rare with standard ophthalmic use but could theoretically cause CNS excitation followed by depression and cardiovascular collapse if massive amounts are absorbed through mucous membranes.
可用產品
劑型
- 0.5% ophthalmic solution (single-use vials)
獸醫用
- Proxymetacaine 0.5% single-use vials
人用標示
- Minims Proxymetacaine Hydrochloride 0.5% eye drops
- Alcaine 0.5% ophthalmic solution
各地核准狀態
Commonly known as Proparacaine in the US.
POM (Prescription Only Medicine)
POM-V
暫無法規資料: 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store in a refrigerator (2-8°C) and protect from light. Efficacy is reduced if stored at room temperature for >2 weeks.
飼主須知
此藥物僅供獸醫在診所內使用，以利進行眼科檢查或小手術。
警告： 此藥物絕不能在家中使用。反覆使用麻醉眼藥水會對眼球表面造成嚴重且可能導致失明的損傷（角膜潰瘍）。在獸醫就診後，當寵物的眼睛仍處於麻醉狀態時，請防止牠們揉搓或抓撓眼睛。
VetSheet 藥物參考供合格獸醫專業人員作臨床決策輔助之用，不能取代專業判斷或廠商最新仿單。