Comparative Pharmacology
Head-to-head clinical analysis: NESACAINE versus POLOCAINE MPF.
Peer-Reviewed Evidence
Head-to-head clinical analysis: NESACAINE versus POLOCAINE MPF.
NESACAINE vs POLOCAINE-MPF
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Nesacaine (chloroprocaine) is an ester-type local anesthetic that blocks voltage-gated sodium channels in neuronal membranes, inhibiting the initiation and conduction of nerve impulses.
Polocaine-MPF (mepivacaine hydrochloride) is an amide-type local anesthetic that blocks sodium ion channels in nerve cell membranes, thereby preventing the initiation and propagation of nerve impulses. This results in reversible loss of sensation in the area of administration.
Injectable local anesthetic: 1% or 2% solution, maximum dose 7 mg/kg (not to exceed 500 mg) with epinephrine, 4.5 mg/kg (not to exceed 300 mg) without epinephrine. Administer by infiltration or nerve block; may repeat at 30-minute intervals.
Adults: 1-2 cartridges (1.8 mL each) of 2% lidocaine with 1:100,000 epinephrine administered via local infiltration or nerve block, not to exceed 7 mg/kg (maximum 500 mg) for lidocaine.
None Documented
None Documented
Terminal half-life: 40-60 minutes (rapidly metabolized by plasma pseudocholinesterase); clinical context: prolonged with hepatic dysfunction or atypical pseudocholinesterase
Terminal elimination half-life: 1.5-2.0 hours in adults; prolonged in hepatic impairment (up to 4-6 hours) and severe renal impairment. Clinical context: short half-life supports continuous infusion for sustained effect.
Renal: 90-95% as unchanged drug and metabolites (predominantly 4-hydroxypropycaine); biliary/fecal: <5%
Renal: >90% as metabolites, primarily 4-hydroxy-2',6'-dimethylacetanilide and pipecoloxylidide; unchanged drug <5%. Biliary/fecal: <5%.
Category C
Category C
Local Anesthetic
Local Anesthetic