Cardiovascular and Neurological Effects of 4,000 mg of Procaine

• Published in: JAMA : the journal of the American Medical Association Vol. 213; no. 4; pp. 621 - 623
• Main Authors: Wikinski, Jaime A, Usubiaga, Jose E, Wikinski, Regina W
• Format: Journal Article
• Language: English
• Published: United States American Medical Association 27-07-1970
• Subjects: Adult; Aminobenzoates - blood; Atropine - therapeutic use; Bis-Trimethylammonium Compounds - therapeutic use; Blood Pressure; Electrocardiography; Heart Conduction System - drug effects; Humans; Hypertension - chemically induced; Male; Medication Errors; Meperidine - therapeutic use; Preanesthetic Medication; Procaine - adverse effects; Procaine - blood; Pupil - drug effects; Reflex, Pupillary; Seizures - chemically induced; Succinylcholine - therapeutic use; Tachycardia - chemically induced; Thiopental - therapeutic use
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.1970.03170300065020

A 39-year-old patient inadvertently received 4,000 mg of procaine hydrochloride following administration of thiopental sodium, hexafluorenium bromide, and succinylcholine chloride. Mydriasis, pupils unreactive to light, arterial hypertension, sinus tachycardia, and deepening and widening of the S wave of the electrocardiogram immediately appeared, and lasted for several minutes. The level of procaine in the blood reached a peak of 96 μg/ml, and declined slowly after that. No generalized convulsions developed. The patient recovered spontaneously with no sequelae, a fact largely attributed to the protective effect of artificial ventilation with 100% oxygen.