Comparison of intrathecal 2-chloroprocaine with bupivacaine in short surgical procedures

Abstract

Background: In the post-Lidocaine spinal era, which went into oblivion owing to TNS, there is a need to substitute its alternative, Bupivacaine, in short surgeries to overcome its limitations. 2-Chloroprocaine is a recent introduction with claims of fast onset and recovery as spinal anaesthetic. The aim of the study is to compare the effect of spinal anaesthesia in short surgical procedures (surgeries lasting <60 minutes) between 0.5 % Bupivacaine (Hyperbaric, 7.5 mg) and 1% Chloroprocaine (40mg). Method: A prospective, randomized controlled study was undertaken with 90 patients of ASA physical status I or II undergoing short surgeries consisting of GROUP C(n=45) who received 4 ml 1% 2-Chloroprocaine (40 mg), and GROUP B(n=45) who received 1.5 ml 0.5% Hyperbaric Bupivacaine, (7.5 mg). Patients were observed for hemodynamic stability, degree and adequacy of sensory / motor block, duration of analgesia and adverse effects. For continuous variables, the summary statistics of mean± standard deviation (SD) were used. Chi-square (χ2) test was used for association between two categorical variables. Results: Mean time of onset of sensory block (Group C-1.6 ± 0.7 min, Group B-2.6 ± 0.8 min) and motor block (Group C-2.7 ± 1.0 min, Group B-3.3 ± 1.0 min) were comparable. Duration of sensory block was 113.9±13.3min (Group C), 168.0±13.1min (Group B) (p<0.001); duration of motor block was 92.7±11.2 min (Group C), 140.1±12.2 min (Group B) (p<0.001); duration of analgesia before any rescue dose was 132.5±12.2 min (Group C), 194.1±12.7 min (Group B) (p<0.001). No statistical significant differences were noted in the hemodynamic parameters between two groups at different intervals. Conclusion: Chloroprocaine has comparable onset of sensory and motor block but faster recovery, making it near ideal spinal anaesthetic agent for short surgical procedures.