Tetracaine powder, also known as lidocaine or lidocaine, is a compound with specific chemical properties and is a topical local anesthetic and analgesic preparation suitable for various needle punctures and surgical anesthesia on the skin and mucous membranes. The principle is that it produces anesthetic effects by blocking the transmission of nerve signals, acting on the sodium channels on the cell membrane, preventing sodium ions from entering nerve cells, thereby inhibiting the transmission of nerve impulses. At the same time, it has a certain degree of danger, so relevant safety regulations and operating procedures should be strictly followed when storing. Keep away from sources of ignition and store in a cool, dry environment. Regularly check the substance to ensure it is in good condition.
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What can tetracaine powder be used for?
Tetracaine powder is commonly used for surface anesthesia in ophthalmology, such as corneal suturing and cataract surgery; Mucosal anesthesia is commonly used in otolaryngology surgeries, such as tonsillectomy and adenoidectomy. Its anesthetic effect can effectively alleviate patients' pain and discomfort, and improve the smooth progress of surgery.
Nerve Block
Epidural block：Tetracaine powder solution with a commonly used concentration of 0.15% 0.3% is used in combination with lidocaine hydrochloride, with a maximum concentration of 0.3%. The commonly used dosage is 4050mg and the maximum dosage is 80mg.
Subarachnoid block:Commonly used mixture (1ml of 1% lidocaine hydrochloride mixed with 1ml of 10% glucose injection and 1ml of 3% ephedrine hydrochloride), with a common dosage of 10mg, 15mg as the limit, and 20mg as the maximum dosage.
Nerve conduction block:The commonly used concentration of this substance solution is 0.1% 0.2%, with a common dosage of 4050mg and a maximum dosage of 100mg.
Mucosal surface anesthesia:The commonly used concentration of this substance solution is 1%. Ophthalmology uses 1% isotonic solution, and otolaryngology uses 1%~2% solution. The limit for one dose is 40mg.
What are the advantages of lidocaine powder compared to other local anesthetics?
Strong and long-lasting anesthetic effect
- Tetracaine powder is a long-acting local anesthetic with strong and long-lasting anesthetic effects. The effect usually takes place within 1 to 3 minutes and can last for 2 to 3 hours of anesthesia.
- Compared with other local anesthetics such as procaine, which have weak or short effects, tetracaine has significant advantages in terms of anesthesia depth and duration.
Strong mucosal penetration ability
- This compound has strong mucosal penetration ability and can quickly penetrate mucosal tissue, exerting anesthetic effects.
- This characteristic makes it particularly suitable for anesthesia on mucosal surfaces, such as the eyes, nose, throat, and urinary tract.
Wide applicability
- This compound can be used not only for mucosal surface anesthesia, but also for nerve block anesthesia, epidural anesthesia, etc.
- In clinical practice, this compound can be used for anesthesia preparation before various surgeries and examinations, such as dentistry, otolaryngology, ophthalmology, as well as subarachnoid block, nerve conduction block, etc.
What are the drawbacks of this compound compared to other local anesthetics?
Toxic effects:
- The compound has high toxicity and a high incidence of toxic reactions. The most common toxic reactions are seizures and other central nervous system manifestations, which are related to its high lipid solubility and rapid absorption characteristics.
- When it is rapidly and massively absorbed, the plasma concentration will rapidly increase, which may lead to central neurotoxicity.
Not applicable to certain anesthesia methods:
- This compound is generally not used for infiltration anesthesia because it has slow onset, poor diffusion, and is prone to poisoning.
- It is also not suitable for intravenous injection and intravenous drip, as its absorption rate is fast, and if it accidentally enters the bloodstream and the dosage is too high, serious toxic reactions may occur.
Has an inhibitory effect on the heart:
- This compound has a quinidine like effect on the heart, which can inhibit the myocardium, reduce myocardial contractility, increase diastolic volume, and decrease cardiac output.
- At high concentrations, lidocaine can inhibit the myocardium, and in severe cases, it may cause heart failure, ventricular fibrillation, or cardiac arrest.
Allergic reactions:
- Tetracaine may cause allergic symptoms such as rash, and patients with severe allergies may experience sudden death after use.
Medication restrictions:
- Due to the toxic effects and inhibitory effects on the heart of tetracaine, its dosage and concentration need to be strictly controlled.
- Patients with heart and kidney dysfunction, as well as those with severe allergies, should not use this medication.
What are the toxic reactions of Tetracaine powder?
This compound is a long-acting ester local anesthetic, and its toxic reactions mainly include the following aspects:
Neurological response
Central nervous system suppression: Excessive lidocaine may cross the blood-brain barrier, leading to decreased membrane stability of nerve cells and causing nerve impulse conduction disorders. This may lead to serious consequences such as loss of consciousness, coma, and even death.
Muscle tremors: Tetracaine may also affect the normal release and transmission of neurotransmitters, increasing postsynaptic membrane excitability and triggering muscle contractions. This will exacerbate pain symptoms or create discomfort, further worsening the condition.
Cardiovascular system response
Slow heart rate: Tetracaine may directly act on the heart, interfering with the electrophysiological activity of myocardial cells, leading to a slow heart rate. However, in severe cases, it can cause bradycardia, cardiac arrest, and other life-threatening conditions.
Blood pressure drop: This compound has the effect of dilating blood vessels, reducing peripheral vascular resistance, and decreasing the amount of blood returning, thereby affecting the pumping function of the heart. This may lead to symptoms such as dizziness and nausea, and in severe cases, shock may occur.
Respiratory system response, cardiac depression
Respiratory failure: It has an anesthetic effect on the central nervous system and may cause abnormal respiratory rhythms, leading to emergency situations such as difficulty breathing and suffocation. Immediate oxygen therapy and supportive treatment are required.
Respiratory system response, cardiac depression
Cardiac suppression: Excessive use of lidocaine can lead to decreased myocardial contractility, decreased cardiac output, and in severe cases, heart failure and other diseases. Meanwhile, due to its excitatory and inhibitory effects on the central nervous system, excessive absorption may lead to seizures. If patients are allergic to the substance, they may also experience allergic reactions such as rash and urticaria, and in severe cases, sudden death may occur.
Conclusion
When using Tetracaine powder, it is necessary to strictly control the dosage and closely monitor the patient's vital signs. Once an abnormal reaction occurs, medication should be stopped immediately and corresponding emergency measures should be taken. At the same time, patients allergic to tetracaine, those with heart and kidney dysfunction, and those with severe allergic constitution should avoid using this drug.