More than one century: Intravenous procaine therapy - A systematic review

Procaine, traditionally introduced as a local anaesthetic, has revealed over more than a century a broad spectrum of systemic, pleiotropic pharmacological properties that far exceed its classical use. More than thirty distinct biological mechanisms have now been identified, including anti-inflammatory, vasodilatory, sympatholytic, membrane-stabilising, neuromodulatory, geroprotective, and epigenetically active effects. These actions provide the scientific foundation for its expanding clinical relevance in pain medicine, neuro-regulation, cardiovascular modulation, immune-related and degenerative disorders, and complementary oncology. Within Neural Therapy, Procaine occupies a central and irreplaceable role: its segmental, interference-field–oriented and autonomic-regulatory actions uniquely position it as the primary agent capable of restoring disturbed vegetative patterns, resolving chronic dysfunctions, and re-establishing physiological self-regulation. Beyond its local anaesthetic function, intravenous Procaine—especially in combination with bicarbonate—demonstrates profound regulatory effects on microcirculation, autonomic balance, inflammatory cascades, and mitochondrial and cellular resilience. The so-called “Procaine reset” reflects its capacity to transiently interrupt maladaptive neural patterns, modulate limbic activation, influence neurotransmitter systems, and restore homeostatic regulatory loops. The addition of bicarbonate prolongs Procaine’s plasma availability, enhances its intracellular penetration, and amplifies its eutrophic and anti-inflammatory properties. Although Procaine remains the primary therapeutic molecule in Neural Therapy, Lidocaine has also been utilised in selected clinical contexts. Lidocaine shares certain membrane-stabilising and anti-inflammatory features; however, its pharmacodynamics, autonomic influence, and regulatory depth are comparatively limited. Thus, Lidocaine may complement specific applications but cannot replace the superior vegetative-regulatory potential documented for Procaine. Procaine-Base infusion, when properly adapted to the patient's acid–base balance, represents a cornerstone therapy in regenerative medicine, improving pain thresholds, vascular perfusion, lymphatic drainage, and emotional equilibrium. Its safety profile—documented in hundreds of thousands of applications—is exceptionally favourable, with adverse effects being rare, transient, and mild. Given rising global burdens of chronic inflammatory, neurodegenerative, cardiovascular, metabolic, and oncologic disorders, Procaine emerges as a valuable multi-target regulatory agent capable of reducing symptom burden, complementing multimodal therapeutic strategies, and potentially lowering long-term health-care costs. Future high quality, large-scale studies are warranted to validate its systemic mechanisms, clarify dose–response relationships, and further integrate Procaine-based therapies into modern evidence-based frameworks.