Prilocaine
Class: Local Anesthetics
ATC Class: N01BB54
VA Class: CN204
Chemical Name: Propanamide, N-(2-methyl-phenyl)-2-(propylamino)-monohydrochloride
CAS Number: 1786-81-8
Brands: Citanest
Introduction
Intermediate-acting local anesthetic (amide type).
Uses for Prilocaine
Dental Anesthesia
Infiltration or nerve block anesthesia in dental procedures.
Prilocaine Dosage and Administration
General
Determine dosage based on anesthetic procedure, depth of anesthesia, area to be anesthetized, vascularity of oral tissues, physical condition of the patient, and individual patient response. Use smallest dose required to produce the desired effect.
Administration
Injection
Administer by infiltration or by nerve block.
Consult specialized references for specific techniques and procedures of administration.
Aspirate prior to administration to guard against intravascular injection.
For maxillary infiltration for short procedures that can be completed within 15 minutes (e.g., procedures involving maxillary anterior teeth), use prilocaine hydrochloride 4% solution without epinephrine. For long procedures or those involving maxillary posterior teeth, use prilocaine hydrochloride 4% solution with epinephrine 1:200,000.
For inferior alveolar block, may use prilocaine hydrochloride alone or in fixed combination with epinephrine; no practical clinical differences between these preparations.
For chemical disinfection of the cartridge unit, use isopropyl (rubbing) alcohol (91%) or ethyl alcohol (70%). Do not use brands that are not of USP grade, since these preparations may contain denaturants that may be injurious to rubber. Because certain metallic ions (e.g., mercury, zinc, copper) have been associated with swelling and edema following local anesthesia, do not use chemical disinfectants containing or releasing these ions. Do not autoclave because solutions of epinephrine and the closures employed in cartridges cannot withstand autoclaving temperatures and pressures.
Dosage
Available as prilocaine hydrochloride and as fixed combination containing prilocaine hydrochloride and epinephrine bitartrate. Dosage expressed in terms of prilocaine hydrochloride.
Pediatric Patients
Dental Anesthesia
Infiltration, Nerve Block
Children <10 years of age: 40 mg (1 mL) of prilocaine hydrochloride 4% solution (with or without epinephrine) is adequate for a procedure involving 1 tooth, 2–3 teeth (maxillary infiltration), or teeth in an entire quadrant (mandibular block).
Adults
Dental Anesthesia
Infiltration, Nerve Block
Initially, 40–80 mg (1–2 mL) of prilocaine hydrochloride 4% solution (with or without epinephrine) usually provides adequate infiltration or major nerve block anesthesia for most routine procedures. (See Prescribing Limits under Dosage and Administration.)
Prescribing Limits
Pediatric Patients
Dental Anesthesia
Infiltration, Nerve Block
For children <10 years of age with normal le...
