Tetracaine

DEA Class; Rx

Common Brand Names; Tetcaine, tetracaine ophthalmic

Local anesthetics prevent generation/conduction of nerve impulses by reducing sodium permeability & increasing action potential threshold

Indicated for Spinal Anesthesia

Hypersensitivity to aminobenzoic acid, sulfites, parabens, or any components of preparation

Spinal anesthesia

Anxiety

Restlessness

Nervousness

Dizziness

Blurred vision

Conjunctival redness

Lacrimation

Photophobia

Tremors

Twitching

Drowsiness

Unconsciousness

Respiratory arrest

Nausea/vomiting

Chills

Tinnitus

Myocardial depression

Hypotension

Cardiac arrest

Tremors

Anaphylactoid reactions (sometimes fatal)

Use preservative-free preparations for spinal or epidural anesthesia

Some formulations may contain sulfites

Use caution in decreased levels of plasma esterases, hyperthyroidism, cardiovascular disease (heart block, rhythm disturbances, shock)

Use caution in the elderly, debilitated patients, obstetrics, or patients with intraabdominal pressure

DO NOT use solutions with epinephrine in distal areas of body (eg, digit, nose, ear, etc)

Addition of vasoconstrictor, epinephrine, will promote local hemostasis, decrease systemic absorption, and increase duration of action

There are no adequate and well-controlled studies in pregnant women; animal developmental and reproductive toxicity studies with tetracaine hydrochloride have not been reported in the published literature

No human data on effect of the drug on fertility available

There are no data to assess whether the drug is excreted in human milk or to assess its effects on milk production/excretion

Adult

Spinal Anesthesia

High, median, low & saddle: 0.2%-0.3% solution

For perineum: 5 mg/dose

For lower extremities: 10 mg/dose

For saddle block: 2-5 mg/dose

Prolonged (2-3 hours): 1% solution

For spinal: 1% solution diluted 1:1 in CSF, administered at 1 mL per 5 seconds

Doses of >15 mg are rarely required, and should only be used in exceptional cases

Ophthalmic

Short term anesthesia: 1-2 gtt into affected eye just prior to evaluation

Minor surgical procedure: 1-2 gtt into affected eye q5-10min

Prolonged surgical procedure: 1-2 gtt into affected eye q5-10min; not to exceed 5 doses

Pediatric