During the past few years there have been references to therapeutic uses of intravenously administered procaine, mostly to produce analgesia (Lundy, 1942;Gordon, 1943;McLachlin, 1945;Allen, 1945) and also to counteract cardiac arrhythmias (Burstein and Marangoni, 1940;Burstein, 1946).Intravenous administration of a drug as toxic as procaine, whether by a single rapid injection or by a slow infusion, involves a consideration of the rates of dilution, diffusion, fixation, excretion, and destruction of the drug in the body. Eggleston and Hatcher (1916) showed that the toxicity of intravenous procaine increased directly with the rate of injection, and Macdonald and Israels (1932) and Hill and Macdonald (1935) demonstrated the same relation for depression of breathing. Eggleston and Hatcher (1916) also showed, by perfusion experiments in cats, that procaine is destroyed in the liver, but, using a biological test for the estimation of procaine concentrations, they observed no destruction of procaine by the blood in dogs. These results were confirmed by Dunlop (1935) in experiments on dogs, in which procaine and p-aminobenzoic acid blood levels were determined by a diazotization method, using /-naphthol as coupling reagent; after hepatectomy he still found some destruction of procaine which was attributed to an action by tissues other than the liver, though blood itself appeared to be inactive. Recently, however, Goldberg, Koster, and Warshaw (1943), Kisch, Koster, andHazard andRavasse (1945) have adapted the Bratton and Marshall (1939) method for sulphonamides to the determination of procaine and p-aminobenzoic acid in blood and tissue fluids. They have shown that the plasma and serum of many species of animals, including man (in whom the effect is most powerful of all), can hydrolyse procaine to p-aminobenzoic acid and diethylaminoethanol. They ascribe this action to the presence of an enzyme, " procaine esterase," which is said to be distinct from cholinesterase, tropinesterase, and lipase.Our work was designed to study procaine blood levels in cats after rapid intravenous injection, or slow infusion at various rates, with the special aim of determining the contributions made by diffusion, fixation, excretion, and destruction to the rapid removal of procaine from the blood. The parts played by the liver and kidney and the effects of physostigmine, neostigmine, methylene blue, and diisopropylfluorophosphonate on procaine metabolism have also been studied.
Chemical reactions involved in experimentsProcaine is hydrolysed as follows.