Chloroprocaine may provide quick sensory, motor function recovery for outpatient knee arthroscopy

Use of chloroprocaine may provide adequate anesthesia with quick recovery of sensory and motor functions for patients undergoing knee arthroscopy in the ambulatory setting, according to results presented at the Regional Anesthesiology and Acute Pain Medicine Meeting.

Elsbeth Wesselink, MD, and colleagues randomly assigned 150 patients undergoing knee arthroscopy in an ambulatory setting to receive a 40-mg spinal injection of either 1% chloroprocaine (Ampres, Sintetica) or 2% prilocaine (Prilotekal, Nordic Group BV). Researchers considered the time to complete recovery from motor blockade, which was defined as the time from injection until patients had a Bromage of zero on a four-point Bromage scale, as the primary outcome. Time to full regression of sensory block, peak sensory block level, mean arterial blood pressure, urine retention needing catheterization, time until hospital discharge, transient neurologic syndrome and patient satisfaction were included as secondary outcome parameters.

“We found that both short-acting spinal anesthetics chloroprocaine and prilocaine using a 40-mg dose result in adequate anesthesia with quick recovery of sensory and motor functions for knee arthroscopy in the ambulatory setting,” Wesselink said in a press release.

However, she noted chloroprocaine resulted in shorter offset time for motor blockade, onset of sensory block and full regression of sensory block compared with prilocaine.

“As a consequence of a faster offset, the time to spontaneous voiding was shorter in patients undergoing spinal anesthesia with chloroprocaine than with prilocaine,” Wesselink said. “As voiding is required for hospital discharge after spinal anesthesia, chloroprocaine has the advantage of a shorter length of stay.”

Although patient satisfaction was the same in both groups, Wesselink noted patients in the chloroprocaine group had a 1-hour faster hospital discharge, which may be clinically and economically relevant for high-volume centers. However, patients in the chloroprocaine group had a faster onset and higher sensory block with more hemodynamic fluctuations, leading to a higher proportion of patients using vasopressors, according to Wesselink.

“At this moment, we are performing a multicenter dose finding study with chloroprocaine in the Netherlands to investigate if a lower dose gives less hemodynamic fluctuations with the same effectiveness,” Wesselink said. – by Casey Tingle

Reference s :

Wesselink E, et al. Abstract 6582. Presented at: Regional Anesthesiology and Acute Pain Medicine Meeting; April 11-13, 2019; Las Vegas.

www.newswise.com/articles/view/710511/?sc=dwhr&xy=10007438

Disclosure: Wesselink reports no relevant financial disclosures.