Trimecaine


Trimecaine is an organic compound used as a local anesthetic and cardial antiarrhythmic. It is white crystalline powder readily soluble in water and ethanol. It is an active ingredient in products available under trademarks Mesdicain, Mesocain, Mesokain and others.

History

Trimecaine is probably a Czech discovery although its preparation was published by Löfgren in 1946.

Action mechanism, pharmacokinetics

Like other local anesthetics belonging in the amide group trimecaine decreases the cell membrane permeability, causes depolarization and shortens the action potential. Anesthetic effect starts in 15 minutes and remains 60–90 minutes. Its biological half-life is ca. 90 minutes. 10% of trimecaine is excreted unchanged. It passes through the hematoencephalic and placental barriers.

Indication

Trimecaine has two main application fields. The first one is local anesthesia. It is used in concentrations 0.4 up to 4%, in some cases in mixtures with adrenaline. The other field is prophylaxis and therapy of ventriculous arrhytmia on myocardial infarction and in cardiosurgery. It is used also for prophylaxis of sympathic reaction during tracheal intubations.

Contraindication

Trimecaine must not be used at hypersensitivity on amide anesthetics, hypervolemia, hypotension, cardial conduction defects, asystole, cardiogenic shock and malignant hyperthermia in anamnesis.

Adverse effects

Rarely allergical reactions may occur. At overdosing a toxical reaction arises - excitation, agitation, dishevelment, visual defects, buzzing in ears, muscle thrill to tremor, in more severe cases somnolence, hyporeflexia, breathing defects to apnea, convulsions.