Indications for NESACAINE-MPF:
Production of local anesthesia by infiltration, peripheral and central nerve block, including lumbar and caudal epidural blocks.
Epidural anesthesia: administer test dose first; monitor for CNS or cardiovascular toxicity. See full labeling for dosing based on procedure. Individualize. Max single recommended dose: 11mg/kg, not to exceed max total dose of 800mg. Debilitated, elderly, acutely ill (cardiac and/or liver disease): reduce dose.
<3yrs: see full labeling. Individualize based on age and weight. ≥3yrs: max 11mg/kg.
Not for subarachnoid administration. Lumbar and caudal epidural anesthesia: caution with existing neurological disease, spinal deformities, septicemia, severe hypertension. To be administered under the supervision of experienced clinicians. Have intubation, artificial respiration, oxygen therapy and reversal agents available. Risk of methemoglobinemia (esp. in G6PD deficiency, congenital or idiopathic methemoglobinemia, cardiac or pulmonary compromise, infants <6 months of age, concurrent exposure to oxidizing agents or metabolites); monitor. Hypotension. Heart block. Monitor cardiovascular and respiratory vital signs. Impaired cardiovascular function. Hepatic impairment. Retrobulbar block. Labor & delivery. Pregnancy (Cat.C). Nursing mothers.
Concomitant sulfonamides: not recommended. Concurrent vasopressor and ergot-type oxytocic drugs may cause severe, persistent hypertension or cerebrovascular accidents. Increased risk of methemoglobinemia when concurrently exposed to nitrates/nitrites, local anesthetics, antineoplastic agents, antibiotics, antimalarials, anticonvulsants, others.
CNS effects (eg, excitation, depression, restlessness, anxiety, dizziness, tremors), cardiovascular effects (eg, myocardium depression, decreased cardiac output, heart block, hypotension, bradycardia, ventricular arrhythmias, cardiac arrest), allergic-type reactions, neurologic effects (eg, spinal block, urinary retention, paresthesia, weakness, headache, paralysis of lower extremities).
Nesacaine: Multi-dose vial (30mL)—25; Nesacaine-MPF: Single-dose vial (20mL)—25