Ultracaine

Introduction
Ultracaine is a prescription medication used as a local anesthetic. It is used during minor surgical procedures such as dental, oral, diagnostic, or other therapeutic procedures to anesthetize or numb the surgical area. This medicine can also be useful in the relief of pain, e.g. during labor. Ultracaine blocks the nerve impulses that send pain signals to your brain and helps to perform a painless procedure by temporarily numbing the surgical area. Like many other medicines, this medicine also has few side effects. The most common side effects of this medicine are nausea, tingling sensation, slow heart rate, high blood pressure, dizziness, inability to empty the urinary bladder, etc. These are usually mild and short-lived. If the numbness or other side effects persist, consult your doctor without delay. Before using Ultracaine, it is very important to tell your doctor if you have any underlying heart disease or are taking medicines for heart rhythm problems. Let your doctor know if you are pregnant or breastfeeding. Also, it is not safe to drive or operate heavy machinery while on medication, unless your doctor permits you to do so.

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Uses of Ultracaine
Local anesthesia (Numb tissues in a specific area)
Side effects of Ultracaine
Common
Nausea
Paresthesia (tingling or pricking sensation)
Slow heart rate
Decreased blood pressure
Dizziness
Urinary retention
High blood pressure
Vomiting
How to use Ultracaine
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Ultracaine works
Ultracaine is a local anesthetic. It works by blocking the transmission of pain signals from the nerves to the brain. This helps to decrease the sensation of pain.
What if you forget to take Ultracaine?
If you miss a dose of Ultracaine, please consult your doctor.
Quick Tips
Ultracaine is given as an injection by the healthcare professional.
It may affect your concentration or make you feel sleepy, so avoid driving or using tools or machines until the next day.
Consult your doctor immediately if you experience dizziness, lightheadedness, problem with sight or hearing or numbness around lips, tongue and mouth.
Inform your doctor if you are pregnant, planning pregnancy or breastfeeding.
Brief Description
Indication
Local anesthesia, Epidural, Intrathecal anesthesia, Epidural analgesia
Adult Dose
Adult: Inj Percutaneous infiltration anesth For prolonged action: 9 mg w/ adrenaline (1 in 200,000), may repeat 2-10 mins later if needed. Max: 90 mg per dental sitting. Surgical anaesthesia Peripheral nerve block 12.5 mg (as 0.25% soln) or 25 mg (as 0.5% soln) . Max: 150 mg/dose. Sympathetic nerve block As 0.25% soln: 50-125 mg. Retrobulbar block As 0.75% soln: 15-30 mg. Caudal block In surgery: 37.5-75 mg (as 0.25% soln) or 75-150 mg (as 0.5% soln). Lumbar epidural block In surgery: 25-50 mg (as 0.25% soln) and 50-100 mg (as 0.5% soln). Spinal block: 0.5% soln: 10-20 mg (2-4 mL). Acute pain Adult: Lumbar block in labour pain: 0.25% soln: 15-30 mg (6-12 mL); 0.375% soln: 22.5-45 mg (6-12 mL); 0.5% soln: 30-60 mg (6-12 mL). Alternatively, 0.1% soln: 10-15 mg (10-15 mL) per hr; 0.125% soln: 10-15 mg (8-12 mL) per hr via infusion. Caudal block in labour pain: 0.25% soln: 25-50 mg (10-20 mL); 0.375% soln: 37.5-75 mg (10-20 mL); 0.5% soln: 50-100 mg (10-20 mL).

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Child Dose
<12 years: Not recommended Caudal Block, Epidural Block, Local Block >12 years Local Anesthesia: Infiltration 0.25% infiltrated locally: 175 mg maximum Caudal Block: 15-30 mL of 0.25% or 0.5% (preservative free) Epidural Block Other Than Caudal Block: 10-20 mL of 0.25% or 0.5%; administer in 3-5 mL increments allowing sufficient time to detect toxic manifestations of inadvertent IV or IT administration (preservative free); for surgical procedures requiring high degree of muscle relaxation and prolonged effects administer10-20 mL of 0.75%; not to be used in obstetrical cases Peripheral or Sympathetic Nerve Block >12 years Peripheral Nerve Block: 5 mL of 0.25-0.5%; 400 mg/day maximum Sympathetic Nerve Block: 20-50 mL of 0.25%

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Contraindication
Hypersensitivity to local anaesthetics of amide type. IV regional anaesthesia; paracervical block in obstetrics; spinal anaesthesia <18 yr. Lactation. Solutions containing preservatives for caudal or epidural block. _ Mode of Action Bupivacaine blocks both the initiation and conduction of nerve impulses reducing the permeability of neuronal membranes to Na ions resulting in inhibition of depolarization w/ resultant blockade of conduction. Precaution Hepatic disease; CV disease; children <12 yr; pregnancy. Elderly and debilitated patients. Lactation: excretion in milk unknown/not recommended _ Side Effect CNS excitation may be followed by depression. Hypotension, bradycardia, arrhythmias and cardiac arrest; methaemoglobinaemia; seizures, restlessness, dizziness. Hypersensitivity. Prolonged block, Edema, Headache, Hypotension, Hypoventilation, Nausea, Nervousness, Palpitation, Respiratory arrest, Tachycardia, Tinnitus, Tremors, Vomiting Potentially Fatal: Cardiac and sudden respiratory arrest. _ Pregnancy Category Note Pregnancy Category: C Lactation: excretion in milk unknown/not recommended _ Interaction Additive systemic toxic effect w/ other local anaesth or agents structurally related to amide-type local anaesth (e.g. lidocaine and mexiletine). Increased risk of myocardial depression w/ antiarrhythmics. Enhanced adverse effects w/ hyaluronidase. Decreased clearance resulting to increased plasma concentrations w/ cimetidine and ranitidine. Increased risk of adverse effects w/ beta-blockers and Ca channel blockers.