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Chloroprocaine 40 mg produces shorter spinal block than articaine 40 mg in day‐case knee arthroscopy patients
Author(s) -
FÖRSTER J. G.,
ROSENBERG P. H.,
HARILAINEN A.,
SANDELIN J.,
PITKÄNEN M. T.
Publication year - 2013
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1111/aas.12107
Subject(s) - medicine , articaine , anesthesia , spinal anesthesia , knee arthroscopy , surgery , arthroscopy , local anesthetic
Background Articaine and chloroprocaine have recently gained interest as short‐acting spinal anaesthetics. Based on previous work comparing articaine 60 mg with chloroprocaine 40 mg, we hypothesised that articaine 40 mg and chloroprocaine 40 mg would produce similar spinal anaesthesa regarding block onset, maximal spread, and recovery. Methods In this randomised, double‐blind study, adult patients (18–70 years, A merican S ociety of A naesthesiologists physical status I ‐ III , BMI < 36 kg/m 2 ) scheduled for day‐case knee arthroscopy received either articaine 40 mg (20 mg/ml) (group A 40, n = 16) or chloroprocaine 40 mg (20 mg/ml) (group C 40, n = 18) intrathecally. Telephone interviews were performed on the first and seventh postoperative day to disclose possible side effects, e.g. transient neurological symptoms ( TNS ). Results The groups were comparable regarding demographic data, onset and maximal spread of spinal anaesthesia, and duration of surgery. Surgery could be performed successfully under spinal anaesthesia except once in A 40 (insufficient block) and once in C 40 (prolonged surgery). Complete recovery was significantly slower in A 40 vs. C 40 for both motor block (105 (94/120) vs. 75 (71/90) min) [ P < 0.001, M ann– W hitney U ‐test ( MW ‐ U )] and sensory block [135 (109/176) vs. 105 min (90/124)] ( P < 0.02, MW ‐ U ), respectively [data are median (25th/75th percentiles)]. One patient from A 40 showed mild TNS . Conclusion Both A 40 and C 40 provided mainly adequate spinal anaesthesia for day‐case knee arthroscopy. While onset and maximal spread were comparable, the recovery from motor block was clearly faster with chloroprocaine after equivalent doses of spinal articaine and chloroprocaine.