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Description of the medicine: Dicainum

DIKAINE (Dicainum) 2-Dimethylaminoethyl ester of para-butylaminobenzoic acid hydrochloride.

Synonyms: Amethocaine, Anethaine, Decicain, Felicain, Foncaine, Intercain, Medicain, Pantocain, Pontocaine hydrochloride, Rexocaine, Tetracaini hydrochloridum, Tetracaine hydrochloride, etc.

White crystalline powder odorless. Easily soluble in water (1:10), alcohol (1: 6).

The solutions are sterilized at +100 ° C for 30 minutes; To stabilize the solutions add a solution of hydrochloric acid to pH 4, 0 - 6, 0.

Dicaine is a strong local anesthetic, significantly superior in activity to novocaine and cocaine, but it has a high toxicity (2 times more toxic than cocaine and 10 times more of novocaine), so it should be used with caution.

Dicaine is used only for superficial anesthesia.

In ophthalmic practice apply in the form of 0.1% solution when measuring intraocular pressure (one drop 2 times with an interval of 1 2 min). Anesthesia usually develops after 1 to 2 minutes. When removing foreign bodies and surgical interventions, 2-3 drops of 0.25-0.5-1% or 2% solution are used. After 1 to 2 minutes, severe anesthesia develops. It should be borne in mind that solutions containing more than 2% of dicaine may cause damage to the corneal epithelium and a significant widening of the conjunctival vessels. Usually, an application of 0.5% solution is sufficient for anesthesia during surgical interventions on the eyes. For lengthening and strengthening the anesthetic effect, add 0.1% solution of adrenaline (3 - 5 drops per 10 ml of dicain).

In keratitis, dicaine is not used.

In ophthalmic practice, if necessary, prolonged anesthesia use ocular films with dicain (Metbranulae orhthalmicae cum Dicaino). Each film contains 0.00075 g (0.75 mg) of dicaine. The basis of the films is a biodegradable polymer.

Dicaine is also used for surface anesthesia in otorhinolaryngological practice with certain surgical interventions (puncture of the maxillary sinus, removal of polyps, conchotomy, operation on the middle ear). Due to the rapid absorption of dicaine mucous membranes of the respiratory tract should be very careful when using it and carefully monitor the patient's condition. Children under 10 years of age do not undergo anesthesia with dicain. In older children, no more than 1-2 ml of 0.5-1% solution is used, in adults up to 3 ml of 1% solution (sometimes enough 0.25-0.5% solution) and only if absolutely necessary - 2% or 3% solution. To a solution of dicaine (in the absence of contraindications to the use of vasoconstrictors) add 1 drop of 0.1% solution of epinephrine hydrochloride to 1 - 2 ml of dicaine.

Instead of dicaine, it is preferable to use less toxic local anesthetics (lidocaine, pyromecaine, etc.).

Higher doses of dicaine for adults with anesthesia of the upper respiratory tract - 0.09 g once (3 ml of a 3% solution).

Doses of dioxin can not be exceeded in order to avoid severe toxic effects. The literature describes cases of deaths associated with overdose and improper intake of dicaine.