Hyperbaric bupivacaine and 2–chloroprocaine for spinal anesthesia in outpatient procedures : a comparative study.

Dr.Manjulata Tandan; Dr.A.M. lakra; Dr.sandeep Bhagat; Dr. S.K.Dwivedi

Volume : VIII, Issue : VI, June - 2018

Hyperbaric bupivacaine and 2–chloroprocaine for spinal anesthesia in outpatient procedures : a comparative study.

Dr. Manjulata Tandan, Dr. A. M. Lakra, Dr. Sandeep Bhagat, Dr. S. K. Dwivedi

Abstract :

Background

Its always been wandered for the ideal local anesthetic agent for spinal anesthesia in outpatient procedures . As Lignocaine is associated with a high incidence of transient neurological symptoms, and bupivacaine produces sensory and motor blocks of long duration. Being a short–acting agent of increasing popularity in recent years ; preservative– free 2–chloroprocaine (2–CP) seems to be a promising alternativeto them. This study was designed to compare 2–CP with bupivacaine for spinal anesthesia in an elective outpatient surgeries.

Methods

After obtaining institutional ethical committee approval and caregivers written informed consent 50 patients of age group 18–60years of ASA grade I & II of either sex undergoingurologic surgeries (i.e.cystoscopy, circumcision, anorectal surgeries i.e. fissure in ano fistula and hemorrhoides, varicocelectomy, and hydrocelectomy) and gynecologic surgeries i.e. (hysteroscopy, vulvar or vaginal biopsy, cystocele repair, dilatation, and curettage) were included in this comparative study. After gettinga detailed history, general and systemic examination and necessary investigations patients were randomly allocated into two groups. In Group Bpatients received spinal anesthesia with 0.75% hyperbaric bupivacaine 7.5 mg (n = 25) andGroup C received 2% preservative–free 2–CP 40 mg (n =25). The primary endpoint for the study was the time reaching the patients ability to get discharged . Secondly our study included the duration of sensory and motor blockades, the length of stay in PACU, the time until ambulation and micturition.

Results

The average time for patients discharge was 245 min in the 2–CP group and 340 min in the bupivacaine group, a difference of 95 min (95% confidence interval [CI]: 40 to 112 min; P < 0.001). The average time for complete regression of the sensory block was 130 min in the 2–CP group and 290 min in the bupivacaine group, a difference of 160 min (95% CI: 159 to 212 min; P < 0.001). Times for ambulation and micturition were also significantly lower in the 2–CP group.

Conclusion

Spinal 2–chloroprocaine provides adequate duration and depth of surgical anesthesia for short procedures with the advantages of faster block resolution and earlier hospital discharge compared with spinal bupivacaine.