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The use of local anesthetics in the treatment of back pain
Last reviewed: 10.08.2022
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Lidocain (Lidocaine)
Solution for intravenous administration, injection, aerosol for topical use, gel for external use, eye drops
Pharmachologic effect
Has antiarrhythmic (lb class) properties. Stabilizes cell membranes, blocks sodium channels, increases membrane permeability for K +. Almost without affecting the electrophysiological state of the atrium, accelerates repolarization in the ventricles, depresses the depolarization phase IV in the Purkinje fibers (especially the ischemic myocardium), reducing their automatism and the duration of the action potential, increases the minimal potential difference at which cardiomyocytes react to premature stimulation.
In therapeutic doses, it improves conductivity in Purkinje fibers and at the site of their connection with ventricular contractile myocardium, thereby helping to eliminate the conditions for the formation of the phenomenon of "re-entry", especially under conditions of ischemic damage to the heart muscle, for example, in myocardial infarction. Shortens the duration of the action potential and effective refractory period.
Virtually does not affect the conductance and contractility of the myocardium (inhibition of conductivity is noted when administered only in large, close to toxic doses) - the duration of the intervals PQ, QT and width of the QRS complex on the ECG does not change. Negative inotropic effect is also expressed slightly and manifests itself briefly only with the rapid administration of the drug in large doses.
Indications for use
Cupping of resistant paroxysms of ventricular tachycardia. Including myocardial infarction and cardiosurgical interventions. Prevention of recurrent ventricular fibrillation in acute coronary syndrome and repeated paroxysms of ventricular tachycardia (usually within 12-24 hours). Ventricular arrhythmias due to glycosidic intoxication.
All kinds of local anesthesia (anesthesia with trauma, surgical interventions, including cesarean section, anesthesia of labor, painful diagnostic procedures, for example, arthroscopy): terminal (superficial) anesthesia, local infiltration anesthesia (subconjunctival), conductive anesthesia (including dentistry , intercostal blockade, cervical vagosympathetic, intravenous regional anesthesia), caudal or lumbar epidural block, spinal (subarachnoid) anesthesia, conductive (ret obulbarnaya, parabulbarno) anesthesia.
Procaine (Procaine)
Injection, ointment for external use, suppositories rectal
Pharmachologic effect
A local anesthetic with moderate anesthetic activity and a large breadth of therapeutic action. Being a weak base, it blocks Ka + channels, prevents the generation of hymns in endings of sensitive nerves and impulses along nerve fibers. Changes the action potential in the membranes of nerve cells without a pronounced effect on the resting potential. Suppresses the carrying out not only painful, but also impulses of other modality.
With absorption and direct vascular injection into the blood flow reduces the excitability of peripheral cholinergic systems, reduces the formation and release of acetylcholine from preganglionic endings (possesses some ganglion-blocking action), eliminates spasm of smooth muscles, reduces the excitability of the myocardium and motor cortex areas of the brain.
With IV administration, analgesic, anti-shock, hypotensive and antiarrhythmic action (increases the effective refractory period, reduces excitability, automatism and conductivity), in large doses can disrupt neuromuscular conduction.
Eliminates the descending inhibitory effects of the reticular formation of the brain stem. Inhibits polysynaptic reflexes. In large doses can cause seizures. Has a short anesthetic activity (duration of infiltration anesthesia is 0.5-1 h).
With the / m introduction 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 vessels of the brain, etc.).
Indications for use
Infiltration (including intraosseous), conductive, epidural, spinal anesthesia; terminal (superficial) anesthesia (in otorhinolaryngology); vagosympathetic cervical and paranephalic blockade, retrobulbar (regional) anesthesia.
Rectal: hemorrhoids, fissures of anus.
Attention!
To simplify the perception of information, this instruction for use of the drug "The 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.