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Use of local anesthetics in the treatment of back pain
Last reviewed: 04.07.2025
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Lidocaine
Intravenous solution, injection solution, topical aerosol, external gel, eye drops
Pharmacological action
It has antiarrhythmic (lb class) properties. It stabilizes cell membranes, blocks sodium channels, increases membrane permeability for K+. Almost without affecting the electrophysiological state of the atrium, it accelerates repolarization in the ventricles, inhibits phase IV depolarization in Purkinje fibers (especially in ischemic myocardium), reducing their automatism and duration of the action potential, increases the minimum potential difference at which cardiomyocytes respond to premature stimulation.
In therapeutic doses, it improves conductivity in the Purkinje fibers and at the site of their connection with the contractile myocardium of the ventricles, thereby helping to eliminate the conditions for the formation of the phenomenon of "re-entry", especially in conditions of ischemic damage to the heart muscle, for example, during myocardial infarction. It shortens the duration of the action potential and the effective refractory period.
It has virtually no effect on myocardial conductivity and contractility (inhibition of conductivity is observed when administered only in large, close to toxic doses) - the duration of the PQ, QT intervals and the width of the QRS complex on the ECG do not change. The negative inotropic effect is also insignificant and manifests itself briefly only with rapid administration of the drug in large doses.
Indications for use
Relief of persistent paroxysms of ventricular tachycardia, including myocardial infarction and cardiac surgery. Prevention of recurrent ventricular fibrillation in acute coronary syndrome and recurrent paroxysms of ventricular tachycardia (usually within 12-24 hours). Ventricular arrhythmias caused by glycoside intoxication.
All types of local anesthesia (pain relief during trauma, surgery, including cesarean section, pain relief during labor, painful diagnostic procedures, such as arthroscopy): terminal (superficial) anesthesia, local infiltration anesthesia (subconjunctival), conduction anesthesia (including in dentistry, intercostal block, cervical vagosympathetic, intravenous regional anesthesia), caudal or lumbar epidural block, spinal (subarachnoid) anesthesia, conduction (retrobulbar, parabulbar) anesthesia.
Procaine (Procaine)
Injection solution, ointment for external use, rectal suppositories
Pharmacological action
A local anesthetic with moderate anesthetic [activity and a wide range of therapeutic action. Being a weak base, it blocks Ka+ channels, prevents the generation of impulses in the endings of sensory nerves and the conduction of impulses along nerve fibers. It changes the action potential in the membranes of nerve cells without a pronounced effect on the resting potential. It suppresses the conduction of not only pain, but also impulses of other modalities.
When absorbed and directly injected into the bloodstream, it reduces the excitability of peripheral cholinergic systems, reduces the formation and release of acetylcholine from preganglionic endings (has some ganglionic blocking action), eliminates smooth muscle spasm, and reduces the excitability of the myocardium and motor zones of the cerebral cortex.
When administered intravenously, it has an analgesic, anti-shock, hypotensive and antiarrhythmic effect (increases the effective refractory period, reduces excitability, automatism and conductivity); in large doses, it can disrupt neuromuscular conductivity.
Eliminates descending inhibitory effects of the reticular formation of the brainstem. Inhibits polysynaptic reflexes. In large doses, it can cause convulsions. It has a short anesthetic activity (the duration of infiltration anesthesia is 0.5-1 h).
When administered intramuscularly, it is effective in elderly patients in the early stages of diseases associated with functional disorders of the central nervous system (arterial hypertension, spasms of the coronary vessels and cerebral vessels, etc.).
Indications for use
Infiltration (including intraosseous), conduction, epidural, spinal anesthesia; terminal (superficial) anesthesia (in otolaryngology); vagosympathetic cervical and paranephric block, retrobulbar (regional) anesthesia.
Rectally: hemorrhoids, anal fissures.
Attention!
To simplify the perception of information, this instruction for use of the drug "Use of local anesthetics in the treatment of back pain" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.