Chloroprocaine (nesacaine), an ester local anesthetic, is a chlorinated derivative of procaine with rapid onset, short duration of action, and reduced acute toxicity due to rapid metabolism (plasma t1/2 ~25 seconds). A higher-than-expected incidence of muscular back pain following epidural anesthesia with 2-chloroprocaine has been reported; this back pain is thought to be due to tetany in the paraspinus muscles, which may be a consequence of Ca2+ binding by the EDTA included as a preservative; the incidence of back pain appears to be related to the volume of drug injected and its use for skin infiltration.
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