Tetracaine (Amethocaine) Injection

What is Tetracaine Injection?
Tetracaine (Amethocaine) Injection is a potent ester-type local anesthetic. It is specifically utilized for its long duration of action compared to other local anesthetics like Lidocaine or Procaine. In clinical settings, it is primarily used for spinal anesthesia when a surgery is expected to last longer than two hours. It is highly lipid-soluble, which contributes to both its potency and its extended effect on nerve fibers.
Uses of Tetracaine Injection
Spinal Anesthesia: Used for procedures involving the lower abdomen, pelvis, and lower extremities (e.g., orthopedic surgeries, vascular repairs).
Saddle Block: Often employed in obstetric or urological procedures where anesthesia is required for the perineal area.
Prolonged Procedures: Ideal for surgeries requiring a dense sensory and motor block lasting 2 to 3 hours or longer.
Surface/Topical Anesthesia: Though this refers to the injectable form, Tetracaine is also widely used topically in ophthalmology and ENT.
How Does Tetracaine Injection Work?
Tetracaine works by blocking sodium ion channels along the nerve fibers. By binding to these channels, it prevents the influx of sodium ions across the cell membrane, which is necessary for the initiation and conduction of nerve impulses. Since the "pain signal" cannot travel to the brain, the patient experiences a complete loss of sensation in the targeted area. Because it is an ester, it is metabolized by the enzyme pseudocholinesterase in the plasma.
FAQs on Tetracaine Injection
1. How long does the effect of Tetracaine last? When used for spinal anesthesia, Tetracaine typically provides a surgical block lasting 2 to 3 hours. When combined with epinephrine (adrenaline), the duration can be extended even further, often up to 4 or 5 hours.
2. What is the difference between Tetracaine and Lidocaine? Tetracaine is significantly more potent and has a longer duration than Lidocaine. While Lidocaine is excellent for short procedures and rapid onset, Tetracaine is preferred for major surgeries where a long-lasting, deep block is required.
3. Are there specific contraindications for ester anesthetics? Yes. Patients with a known allergy to other ester-type anesthetics (like Procaine or Benzocaine) or those with a deficiency in the enzyme pseudocholinesterase should avoid Tetracaine, as they may have difficulty metabolizing the drug, leading to prolonged effects or toxicity.
Therapeutic Category
Anesthetics (Local/Spinal Anesthetic)
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