Las Vegas, Nevada: In patients undergoing knee arthroscopy, chloroprocaine results in adequate anesthesia and provides quick recovery of sensory/motor functions in the ambulatory setting. These are the results of a recent study presented at the Annual Regional Anesthesiology and Acute Pain Medicine Meeting, held from April 11 to 13 in Las Vegas.
A short-acting spinal anesthetic facilitates a smooth patient flow: quick recovery of motor function will facilitate unassisted ambulation. Elsbeth Wesselink, Zaans Medical Center in Zaandam, Netherlands, and colleagues conducted a prospective study to compare the effects of spinal chloroprocaine and spinal prilocaine on motor blockade in patients undergoing knee arthroscopy.
The study involved 150 patients undergoing knee arthroscopy in day-case surgery. Patients were randomly assigned to either a spinal injection of 40 mg 2-chloroproca0ine or hyperbaric prilocaine.
Primary outcome was the time to complete recovery from motor blockade defined as the time from injection of the study drug until the subject had a Bromage of 0 on a 4-point Bromage scale (0-3).
Key findings of the study include:
- Prilocaine, chloroprocaine resulted in a shorter time to complete recovery from motor blockade (median, 60 versus 75 minutes), faster onset of sensory block (median, two versus four minutes), and shorter times to full regression of sensory block (median, 120 versus 165 minutes) and discharge home (mean, 3.7 versus 4.7 hours).
- The chloroprocaine group had higher peak sensory block (median T9 versus T10).
- At 20 minutes, mean arterial blood pressure was lower and the use of vasopressor drugs was higher (22.7 versus 10 percent) in the chloroprocaine versus the prilocaine group.
- There was no difference between the groups in terms of frequency and type of medication for postoperative pain management.
- On days 1 and 7, patient satisfaction did not differ between the groups.
The results “confirm earlier observations that both short-acting spinal anesthetics chloroprocaine and prilocaine result in adequate anesthesia with quick recovery of sensory/motor functions for knee arthroscopy in the ambulatory setting,” write the authors.