Novocaine: Uses, Side Effects, and Risks

Novocaine , also called procaine , is an injectable anesthetic that prevents pain by numbing a small, localized area. Once one of the most common local anesthetics used by dentists, Novocaine has been replaced by newer local anesthetics such as lidocaine. Generally speaking, the word "novocaine" is now used to describe various types of local anesthesia .

This article reviews the uses, side effects, and risks of novocaine N-(Tert-Butoxycarbonyl)-4-Piperidone

Novocaine: Uses, Side Effects, and Risks

Technically, the words "procaine" and "novocaine" are synonymous and may be used interchangeably. "Novocain" is a trade name for the generic drug procaine. Just like Band-Aid and Kleenex are brand names that became household words to describe adhesive bandages and facial tissues, respectively, the word "novocaine" (with an "e") has become a generic term.

The word "novocaine" is often used to describe various types of local anesthesia, such as Xylocaine (lidocaine ), Citanest (prilocaine ), or Septocaine (articaine ).

Novocaine causes numbness in a localized area for a brief amount of time. It is used for procedures that don't require a longer-lasting anesthetic. It's also used when people are allergic to amide-based drugs (a group of local anesthetic compounds).

Novocaine is administered via injection and used before medical or dental procedures that don't require general anesthesia to put patients in a sleeplike state.

Novocaine's numbing effects usually start within minutes. Its pain-relieving ability lasts about 30–60 minutes. Because novocaine is fast-acting and doesn't last very long, it's often used for quick procedures.

Novocaine is used during same-day procedures such as:

Lidocaine is an amide-based local anesthetic that is more potent and lasts longer than novocaine. Since the 1970s, numerous other local anesthetics in the "-caine" family (e.g., articaine, mepivacaine, and prilocaine) have been developed. Though extremely rare, some people are allergic to amide local anesthetics. In these cases, novocaine is often used as a substitute because it's ester-based.

Novocaine is generally well-tolerated and comes few adverse side effects. The most common adverse reactions occur at the injection site.

The most commonly reported adverse reactions to local anesthesia include:

Anxiety, flushing, itching, shortness of breath, and hives (urticaria) have been observed after administration of novocaine.

Contact a healthcare provider immediately if you experience any of the following severe adverse side effects after a novocaine injection:

Because epinephrine (adrenaline) is often mixed with novocaine to extend its duration of action, many of the side effects associated with procaine are actually caused by the epinephrine. For example, some people experience an adrenaline rush after being given novocaine. This is most likely caused by the epinephrine additive and is not an allergic reaction.

Most adverse reactions to local anesthesia occur within the first two hours after the injection. If you experience any of these symptoms for longer than four to six hours, contact a healthcare provider. In emergencies, call 911.

Severe allergic reactions to local anesthetics like novocaine are extremely rare. At most, they represent less than 1% of the reported adverse reactions to local anesthetics. This means over 99% of side effects are mild.

Although novocaine allergies are rare, ester anesthetics do contain para-aminobenzoic acid (PABA), which is a known allergen. Notably, a preservative (methylparaben ) used in amide-based drugs is metabolized as PABA and may cause allergies. People who are allergic to ester local anesthetics should be treated with an amide-type local anesthetic without preservatives.

A small number of people have a genetic predisposition that makes it hard for their bodies to metabolize ester-type local anesthetics like novocaine. If novocaine isn't metabolized, it causes severe side effects such as being unable to breath or move for a few hours. These cases require immediate medical attention.

Another risk of novocaine is self-injuring the numbed area after the procedure is completed when going about your daily activities. Always exercise extreme caution when eating or drinking if your mouth is still numb. Any body part that is numb from novocaine can accidentally be self-injured.

Novocaine is a broadly used term referring to any type of local anesthetic. Technically speaking, novocaine is the same as procaine, which is an ester local anesthetic. Today, lidocaine is more commonly used than novocaine. Most of novocaine's adverse side effects occur at the injection site and are mild.

In extremely rare cases, some people can't metabolize ester local anesthetics and may have a severe reaction to novocaine. If a family member has ever had an allergic reaction to anesthesia, be sure to share this information with your healthcare provider.

Novocaine is a helpful tool that can reduce pain during uncomfortable or even frightening procedures. Be sure to discuss what, if any, anesthetics your healthcare provider may be using during your procedure so that you feel safe and comfortable at your visit.

Novocaine typically lasts for about 30–60 minutes. Sometimes epinephrine is mixed with novocaine to make it last longer. A novocaine/epinephrine mixture can last for up to 90 minutes.

Lidocaine and other amide-type local anesthetics are common substitutes for novocaine, which is ester-based. The amide family of anesthetics includes articaine, bupivacaine, lidocaine, mepivacaine, prilocaine, and ropivacaine, among others.

Novocaine is used to numb pain during short medical or dental procedures. Because it's fast-acting and doesn't cause numbness for an extended period of time, novocaine is used for minor same-day surgery and dental procedures that take less than an hour.

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By Christopher Bergland Christopher Bergland is a retired ultra-endurance athlete turned medical writer and science reporter. 

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Novocaine: Uses, Side Effects, and Risks

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