chloroprocaine hydrochloride: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
chloroprocaine hydrochloride: clinical details
Prescribing considerations
- For intrathecal administration by clinicians experienced in spinal anaesthesia and resuscitation.
- Establish reliable venous access and ensure airway, oxygen and resuscitation facilities are immediately available.
- Assess cardiovascular status, liver or kidney disease, neurological disease, porphyria and plasma-cholinesterase deficiency.
- Safety and efficacy have not been established in children or adolescents.
- Do not mix with other medicines because compatibility data are unavailable.
Contraindications and cautions
- Hypersensitivity to chloroprocaine, PABA-ester medicines, other ester local anaesthetics or an excipient.
- General or procedure-specific contraindications to spinal anaesthesia, including hypovolaemic shock or decompensated cardiac failure.
- Intravenous regional anaesthesia.
- Serious cardiac-conduction disorders.
- Severe anaemia.
- Anticoagulant treatment or congenital or acquired bleeding disorders.
Monitoring
- Continuously assess vital functions and maintain verbal contact during administration.
- Watch for hypotension, bradycardia, high spinal block, respiratory depression and neurological complications.
- Use careful observation and ECG monitoring with class III antiarrhythmics.
- Confirm recovery of motor, sensory and bladder function before discharge according to local practice.
Clinical pharmacology
Chloroprocaine inhibits nerve-impulse generation and conduction. It is rapidly hydrolysed in plasma by pseudocholinesterase; its metabolites are excreted in urine. Intrathecal systemic exposure is expected to be low.
Formulation and product differences
- Clear, colourless 10 mg/ml solution in a single-use 5 ml glass ampoule.
- Contains sodium chloride, water for injection and hydrochloric acid for pH adjustment; considered essentially sodium-free per administered dose.
- Use immediately after opening and only if clear and practically free from particles.
chloroprocaine hydrochloride preparations and strengths
Injection
Route: Parenteral
Strengths: 10 mg/mL
chloroprocaine hydrochloride interactions
The anaesthetist should review all medicines before administration. Important interactions include:
Sulfonamide antibacterials
A chloroprocaine metabolite may inhibit their antibacterial action, so concurrent use should be avoided.
Class III antiarrhythmics, such as amiodarone
Cardiac effects may be additive; careful observation and ECG monitoring are advised.
Other local anaesthetics
Cardiovascular and central nervous system effects may be additive.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.