Comparitive Study of (1% ) 2-Chlorprocaine Versus 0.5 % Hyperbaric Bupivacaine for Spinal Anaesthesia for Ambulatory Surgeries: A Prospective Randomized Study"

Abstract

Aim :This Study was performed to compare the anaesthetic efficacy and safety of two local anaesthetic agents :2-Chlorprocaine and Hyperbaric Bupivacaine ,in patients undergoing ambulatory surgeries. Methods and materials :Hundred patients ,ASA I-II, were randomized to receive an intrathecal injection of 2- Chlorprocaine or Hyperbaric Bupivacaine .Group A (n=50 ) received 4ml of Chlorprocaine10mg/ml (40mg ).Group B (n=50 ) received 1.5ml of Hyperbaric Bupivacaine 5mg/ml (7.5mg ). Onset and duration of sensory and motor blockade, hemodynamic changes, recovery parameters, side effects for the two agents were compared. Results:Time of onset of sensory block was faster in Group B (2.20±0.45) when compared with Group A (2.40±0.57 ). In Group B time to two segment sensory regression was prolonged (55.38±1.92 ) when compared with Group A (54.55±1.44 ) and it is statistically significant. Duration of Motor blockade was prolonged in Group B (92.24±5.7 ) when compared with Group A (67.69±4.61 ). Hemodynamic variables were more stable in Group A than Group B . Time to ambulation was prolonged in Group B (166.40±4.50) when compared with Group A (154.04±2.49 ). Time to micturition was prolonged in Group B (303.16±2.08) when compared with Group A (267.36 ±3.72 ). Time to stimulated discharge was prolonged in Group B (148.71±4.12 ) when compared with Group A (124.20±3.45 ). 34 patients in Group B had adverse effects when compared with 26 patients in Group A .Conclusion: Intrathecal 1% 2-Chlorprocaine compared with 0.5 % Hyperbaric Bupivacaine results in a significantly faster recovery of sensory and motor blocks. Time to mobilization, voiding, discharge were significantly shorter for 2-chlorprocaine than 0.5% Hyperbaric Bupivacaine. We concluded that 2-chlorprocaine represents an appropriate choice for spinal blocks for short or ultra short surgical procedures.