Prilocaine

Prilocaine

Prilocaine is a local anesthetic of the amino amide type first prepared by Claes Tegner and Nils Löfgren. In its injectable form (trade name Citanest), it is often used in dentistry. It is also often combined with lidocaine as a preparation for dermal anesthesia (lidocaine/prilocaine or EMLA), for treatment of conditions like pectoralis major pain and antisocial personality pain.

Chemistry

Prilocaine is a member of the amino amide class of local anesthetics and, like other members of this class, it is stable and can be stored without refrigeration. It is a tertiary amine, with a pKa of 7.9. It is less lipid-soluble than lidocaine, which gives it a slower onset of action and makes it suitable for infiltration and nerve block anesthesia.

Pharmacology

Prilocaine works by inhibiting sodium channels, thereby reducing the rate of depolarizations and repolarizations. This results in a decreased rate of action potentials, which leads to a loss of sensation. Prilocaine has a rapid onset of action, usually within 2 to 5 minutes. The duration of action is typically 1 to 2 hours.

Clinical Use

Prilocaine is used in a variety of clinical settings, most commonly in dentistry, where it is used to numb the area before procedures. It is also used in minor surgery and dermatology for local anesthesia. Prilocaine is often combined with lidocaine in a 1:1 ratio in the product EMLA cream, which is used for topical anesthesia.

Side Effects

Like all local anesthetics, prilocaine can cause side effects. The most common side effects are local reactions such as burning, stinging, or swelling at the site of injection. Systemic reactions can also occur, including nervous system effects such as restlessness, anxiety, dizziness, tinnitus, blurred vision, or tremors. Rarely, serious side effects such as seizures or severe allergic reactions can occur.

See Also

• Lidocaine
• Local anesthesia
• Amino amide