Overview
Chloroprocaine is a short-acting local anesthetic of the ester type, primarily used for spinal, epidural, and peripheral nerve block anesthesia. It is characterized by rapid onset and short duration of action, making it suitable for procedures requiring brief anesthesia. It is metabolized by plasma cholinesterase.
Mechanism of Action
Chloroprocaine blocks nerve conduction by inhibiting sodium ion influx through voltage-gated sodium channels in neuronal cell membranes, thereby preventing depolarization and propagation of action potentials. As an ester local anesthetic, it is hydrolyzed by plasma cholinesterase.
Indications
- Spinal anesthesia
- Epidural anesthesia
- Peripheral nerve block
- Infiltration anesthesia
Dosage
Dosage varies based on procedure, patient factors, and concentration. For epidural anesthesia: 2-3% solution, 15-25 mL. For spinal anesthesia: 1% solution, 2-3 mL. Maximum recommended dose: 11 mg/kg or 800 mg total. Always follow specific product labeling and clinical guidelines.
Contraindications
- Hypersensitivity to chloroprocaine or other ester local anesthetics
- Severe hypotension
- Spinal block in patients with infection at injection site
- Patients with atypical plasma cholinesterase (if known)
Side Effects
- Hypotension
- Bradycardia
- Nausea/vomiting
- Headache
- Back pain
- Urinary retention
- Transient neurological symptoms (rare)
- Allergic reactions
- Methemoglobinemia (rare)
Interactions
- Cholinesterase inhibitors (e.g., neostigmine) may reduce metabolism
- Sulfonamides may increase risk of methemoglobinemia
- Other local anesthetics may have additive toxic effects