Prilocaine is an amide local anesthetic with similar anesthesia intensity and speed to lidocaine, but longer duration and weaker effect on vasodilation. Toxicity is lower than lidocaine. It is clinically used for local anesthesia, especially for patients who are contraindicated with epinephrine.
Pharmacology
Its 3% solution is equivalent to the local anesthetic effect of 2% lidocaine plus epinephrine. Epinephrine slightly prolongs its duration of action. PPB is 55%, T1/2 is about 1.5h. Intrahepatic metabolism, its metabolite nitrosotoluidine can oxidize hemoglobin to form methemoglobin. It can be transferred to the fetus through the placenta.
Preparation
o-Toluidine and α-bromopropionyl bromide are condensed and then carry out propylamination reaction with propylamine to obtain prilocaine.
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