M R Hejtmanek1, J E Pollock. 1. Department of Anesthesiology, Virginia Mason Medical Center, Seattle, WA 98101, USA.
Abstract
BACKGROUND: Recent volunteer and clinical studies of chloroprocaine (CP) have evaluated its use for outpatient spinal anesthesia. This retrospective review describes the discharge characteristics and reported side effects of spinal CP in a large number of patients undergoing outpatient procedures. METHODS: All patients who received spinal anesthesia for ambulatory procedures over a 20-month period were accessed using computer-generated reports. Charts from 601 anesthetics were analyzed for spinal drug used, block characteristics, side effects and discharge data. RESULTS: CP was the most frequently used spinal anesthetic (84% of cases, n=503) for outpatient procedures. CP (median dose 40 mg, range 20-60 mg) times from injection to ambulation and discharge were 107±24 and 171±45 min, respectively. Lidocaine (median dose 60 mg, range 30-100 mg, n=84) times from injection to ambulation and discharge were 155±40 and 224±57 min, respectively (P<0.05). The incidence of urinary retention, the most common side effect, was similar in both groups. There were no reports of transient neurologic symptoms. CONCLUSIONS: For ambulatory patients at our institution, the time to achievement of discharge criteria was significantly reduced with CP 40 vs. lidocaine 60 mg. There have been no reports of perioperative neurologic injury with the introduction of CP as a spinal anesthetic at our institution.
BACKGROUND: Recent volunteer and clinical studies of chloroprocaine (CP) have evaluated its use for outpatient spinal anesthesia. This retrospective review describes the discharge characteristics and reported side effects of spinal CP in a large number of patients undergoing outpatient procedures. METHODS: All patients who received spinal anesthesia for ambulatory procedures over a 20-month period were accessed using computer-generated reports. Charts from 601 anesthetics were analyzed for spinal drug used, block characteristics, side effects and discharge data. RESULTS: CP was the most frequently used spinal anesthetic (84% of cases, n=503) for outpatient procedures. CP (median dose 40 mg, range 20-60 mg) times from injection to ambulation and discharge were 107±24 and 171±45 min, respectively. Lidocaine (median dose 60 mg, range 30-100 mg, n=84) times from injection to ambulation and discharge were 155±40 and 224±57 min, respectively (P<0.05). The incidence of urinary retention, the most common side effect, was similar in both groups. There were no reports of transient neurologic symptoms. CONCLUSIONS: For ambulatory patients at our institution, the time to achievement of discharge criteria was significantly reduced with CP 40 vs. lidocaine 60 mg. There have been no reports of perioperative neurologic injury with the introduction of CP as a spinal anesthetic at our institution.