Daniela Ghisi1, Giorgia Boschetto2, Alessandra Maria Spinelli3, Sandra Giannone4, Jacopo Frugiuele4, Marcello Ciccarello5, Stefano Bonarelli4. 1. Anesthesia, Intensive Care and Pain Therapy, Istituto Ortopedico Rizzoli, via G.C. Pupilli 1, 40136, Bologna, Italy. ghisidan@gmail.com. 2. Institute of Anesthesiology and Intensive Care, Azienda Ospedaliera di Padova-Universita' degli Studi di Padova, via C. Battisti 267, 35128, Padova, Italy. 3. Anesthesia, Intensive Care and Pain Therapy, Ospedale G. e C. Mazzoni, via degli Iris 1, 63100, Ascoli Piceno, Italy. 4. Anesthesia, Intensive Care and Pain Therapy, Istituto Ortopedico Rizzoli, via G.C. Pupilli 1, 40136, Bologna, Italy. 5. Anesthesia, Intensive Care and Pain Therapy, Dipartimento Rizzoli-Sicilia, Istituto Ortopedico Rizzoli, SS 113 al Km 246, 90011, Bagheria, Italy.
Abstract
BACKGROUND: This prospective, randomised, observer-blinded study has been conducted in patients undergoing procedures of the lower extremities to evaluate the time to complete block resolution of 2-chloroprocaine 1% at three intrathecal doses (30, 40 and 50 mg). METHODS: After informed consent, we enrolled 45 male and female patients, aged 18-65 years, ASA score I-II, BMI 18-32 kg/m2, undergoing elective lower limb procedures lasting ≤40 min and with a requested dermatomeric level of sensory block ≥ T12. The patients were randomised in a 1:1:1 ratio to receive Chloroprocaine HCl 1% at one of the three different intrathecal doses (Group 30 = 30 mg, Group 40 = 40 mg or Group 50 = 50 mg). The progression and regression of both sensory and motor blocks were evaluated blindly. Urine and venous blood samples were collected for pharmacokinetic analysis. RESULTS: Times to regression of spinal blocks were 1.76 ± 0.35 h, 2.13 ± 0.46 h and 2.23 ± 0.38 h, in Group 30, 40 and 50 respectively: the 30 mg dose showed a significantly faster resolution of spinal block than the 40 mg (p = 0.034) and the 50 mg (p = 0.006). Time to readiness for surgery was significantly reduced with the dose of 50 mg when compared to dose of 30 mg (p = 0.0259). CONCLUSIONS: The doses of 50 mg and 40 mg yielded a longer resolution of spinal block than the dose of 30 mg. Nevertheless, the dose of 30 mg resulted in a higher secondary failure rate. TRIAL REGISTRATION: Registration of clinical trial: clinicaltrials.gov ( NCT02481505 ).
BACKGROUND: This prospective, randomised, observer-blinded study has been conducted in patients undergoing procedures of the lower extremities to evaluate the time to complete block resolution of 2-chloroprocaine 1% at three intrathecal doses (30, 40 and 50 mg). METHODS: After informed consent, we enrolled 45 male and female patients, aged 18-65 years, ASA score I-II, BMI 18-32 kg/m2, undergoing elective lower limb procedures lasting ≤40 min and with a requested dermatomeric level of sensory block ≥ T12. The patients were randomised in a 1:1:1 ratio to receive Chloroprocaine HCl 1% at one of the three different intrathecal doses (Group 30 = 30 mg, Group 40 = 40 mg or Group 50 = 50 mg). The progression and regression of both sensory and motor blocks were evaluated blindly. Urine and venous blood samples were collected for pharmacokinetic analysis. RESULTS: Times to regression of spinal blocks were 1.76 ± 0.35 h, 2.13 ± 0.46 h and 2.23 ± 0.38 h, in Group 30, 40 and 50 respectively: the 30 mg dose showed a significantly faster resolution of spinal block than the 40 mg (p = 0.034) and the 50 mg (p = 0.006). Time to readiness for surgery was significantly reduced with the dose of 50 mg when compared to dose of 30 mg (p = 0.0259). CONCLUSIONS: The doses of 50 mg and 40 mg yielded a longer resolution of spinal block than the dose of 30 mg. Nevertheless, the dose of 30 mg resulted in a higher secondary failure rate. TRIAL REGISTRATION: Registration of clinical trial: clinicaltrials.gov ( NCT02481505 ).
Authors: T K Abboud; A Afrasiabi; F Sarkis; F Daftarian; S Nagappala; R Noueihed; B R Kuhnert; F Miller Journal: Anesth Analg Date: 1984-04 Impact factor: 5.108
Authors: Volker Gebhardt; Vera Zawierucha; Oliver Schöffski; Anke Schwarz; Christel Weiss; Marc D Schmittner Journal: Eur J Anaesthesiol Date: 2018-10 Impact factor: 4.330
Authors: An Teunkens; Kristien Vermeulen; Elke Van Gerven; Steffen Fieuws; Marc Van de Velde; Steffen Rex Journal: Reg Anesth Pain Med Date: 2016 Sep-Oct Impact factor: 6.288