A randomized double blind study to compare 1% 2-chloroprocaine and 0.5% hyperbaric bupivacaine in spinal anesthesia for infra-umbilical surgeries

Khare, Arvind; Thada, Beena; Yadav, Devraj

doi:10.35975/apic.v23i2.1061

Cited by 6 publications

(22 citation statements)

References 16 publications

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“…No adverse event was reported among the groups. This is in accordance with the study reporting a 'zero' incidence with 2-chloroprocaine in over 4000 patients compared with 17-33% using lidocaine or 1% using bupivacaine [10][11][12]. Despite the fact that this study wasn't designed to measure health care costs in our rural area setup, our results could be significant when considered from a cost savings perspective.…”

Section: Group Csupporting

confidence: 90%

“…The average time to ambulation was shorter (142.5 vs. 290.5min) in the chloroprocaine group as was the average time to complete regression of sensory block (105 vs. 225 min). Similar results were also reported by Kalra et al [1] and C. Camponovo et al [10] In a similar study by Lacasse et [8] where spinal anaesthesia was achieved with 2% preservative-free 2-chloroprocaine 40mg or 0.75%, hyperbaric bupivacaine 7.5 mg, time to ambulation was 225±56 minutes vs 265±65 minutes (P-value=0.001).…”

Section: Group Csupporting

confidence: 87%

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Comparison of 0.5% hyperbaric bupivacaine versus 1% chloroprocaine in spinal anaesthesia in day care surgeries

Singam

Bhardwaj²

2022

ijhs

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Background: An increasing number of day-care surgical patients are challenging the presently used methods of anesthesia. Reliable surgical anesthesia should be fast, with rapid recovery and minimal side effects. To produce reliable spinal anesthesia with a reasonable recovery time it is essential to understand the factors affecting the spread of spinal block and to choose the optimal drug and adequate dose for special surgical procedures. Bupivacaine may provide prolonged postoperative analgesia and has a lower incidence of TNS. A new formulation 2-Chloroprocaine is characterized by both a very fast onset (5-10minutes) and a quick 13-14 recovery time (70-150minutes). Methods: 40 ASA I/II patients were evaluated for time for ambulation, onset, and duration of sensory blockade, after randomly allocating them into two groups namely Group C(Chloroprocaine) and Group B (Bupivacaine). Results: The time to the first ambulation after spinal anaesthesia was shorter in the Group C(Chloroprocaine) (183.11±14.17min) as compared with Group B(bupivacaine) (274.63±18.21 min) in respect of day-care surgeries. Thus ,the onset and shorter duration of sensory block was observed in Group C as compared to Group B respectively (p<0.05). Similarly, time to ambulate was found to be shorter in Group C as compared to Group B respectively (p<0.05).

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Section: Group Csupporting

confidence: 90%

Section: Group Csupporting

confidence: 87%

Comparison of 0.5% hyperbaric bupivacaine versus 1% chloroprocaine in spinal anaesthesia in day care surgeries

Singam

Bhardwaj²

2022

ijhs

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“…However, patients who received dexmedetomidine had increased mean RSS as compared to the control and dexamethasone group. Similarly higher sedation score in patients receiving dexmedetomidine as adjuvant was also reported in different studies [14,21,23].…”

Section: Discussionsupporting

confidence: 79%

“…Incidence of complications is more in blind TAP block technique than USG-guided TAP blocks. USG-guided drug administration allows accurate deposition of local anesthetic in the correct neurovascular plane and avoid procedure-related complications such as injury to surrounding viscera, transient femoral nerve palsy, and high volume of drug used which can cross the serum toxic levels [23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Levobupivacaine With Two Different Adjuvants (Dexamethasone vs. Dexmedetomidine) in Ultrasonography-Guided Transversus Abdominis Plane Block for Unilateral Inguinal Herniorrhaphy: A Randomized Double-Blinded Control Trial

Partani,

Karia,

Sharma

et al. 2024

Asian J Pharm Clin Res

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Objectives: Ultrasonography (USG)-guided transversus abdominis plane (TAP) block is an effective technique for postoperative analgesia in patients undergoing intraabdominal surgery. This study was aimed to compare the post-operative analgesia, hemodynamic variables, sedation, and adverse effects of levobupivacaine with two different adjuvants (dexamethasone and dexmedetomidine) in USG-guided TAP block for patients undergoing unilateral inguinal herniorrhaphy under subarachnoid block. Methods: A double-blind randomized control study, conducted on 96 patients, allocated in three groups of 32 each. Patients in group C received 0.25% levobupivacaine (20 mL) with normal saline (2 mL), group D1 received 0.25% levobupivacaine (20 mL) added with 0.1 mg/kg dexamethasone (2 mL) and group D2 received 0.25% levobupivacaine added with 0.5 mcg/kg dexmedetomidine diluted in NS (2 mL). Pain was assessed using Visual Analog Scale (VAS). The time for request of first analgesia (TFA), total number and total dose of rescue analgesic in 24 h were recorded. Statistical analysis was done using unpaired Student’s t-test and ANOVA. Results: At 12 and 24 h >30% of patients had VAS ≥4 in control group while it was <10% in groups D1 and D2 (p<0.001). TFA was earliest in control group (6.10±0.96 h) as compared to group D1 (7.26±1.22 h) and group D2 (7.49±1.02 h) (p<0.001). The total number and total dose of analgesic given were higher in the control group than other two groups (p<0.001). However, it was comparable between groups D1 and D2 (p<0.05). Conclusion: Dexamethasone and dexmedetomidine when added as an adjuvant to levobupivacaine for TAP significantly prolonged the duration of post-operative analgesia as compared to levobupivacaine alone, however, it was found to be comparable between adjuvant groups.

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“…Ambulatory anaesthesia offers various advantages, like reduced risk of nosocomial infections, cost reduction, and a short duration of hospital stay [ 2 ]. Spinal anaesthesia is the most convenient anaesthetic technique and is commonly used in surgeries below the umbilicus [ 3 ]. Its advantages over general anaesthesia are reduced stress response, rapidity in onset, post-operative pain relief, shorter hospital stay, and cost-effectiveness [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

A Comparative Study of Isobaric 1% Chloroprocaine With 0.5% Isobaric Bupivacaine for Ureteroscopic Lithotripsy Under Spinal Anaesthesia: A Prospective Randomised Study

Sugumar.¹,

Singh²,

Rath³

et al. 2022

Cureus

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Introduction Day-care surgery has become an immensely popular modality of treatment throughout the globe. Ureteroscopic lithotripsy (URSL) surgery is commonly performed on a day-care basis, and the duration of surgery ranges from 15 minutes to 45 minutes. URSL is routinely done under spinal anaesthesia. Spinal anaesthesia with conventional drugs has its problems like delayed regression and urinary retention, necessitating a longer hospital stay, thereby increasing the time and resources needed. For day-care surgery, short-acting local anaesthetics have a quicker onset with fewer side effects, and drugs that ensure quicker hospital discharge are more often preferred over long-acting anaesthetics. For spinal anaesthesia, we planned to perform a randomised prospective study to compare the effectiveness of 40 mg of preservative-free 1% chloroprocaine over 10 mg of plain 0.5% isobaric bupivacaine. Materials and method After obtaining clearance from the institute’s ethical committee and written informed consent from the patients, 64 patients between the ages of 18 and 50 years of either sex belonging to American Society of Anesthesiologists (ASA) 1 and 2 scheduled for URSL surgery were included in our study. They were randomised using a computer-generated sealed envelope technique into two groups. Group C received 4 ml of 1% isobaric chloroprocaine, and group B received 2 ml of 0.5% isobaric bupivacaine in the intrathecal space. The primary outcome was to compare the in-hospital time among both groups. Our secondary outcomes were the onset time of motor and sensory blocks, the duration of the blocks, time to unaided ambulation and voiding, the need for an overnight stay, and the side effects like postoperative nausea and vomiting (PONV), and urinary retention. The data were analysed using the unpaired t-test and chi-square test and calculated by SPSS 20.0 software version (IBM Corp., Armonk, NY). Results Final analyses were done among 60 patients. In-hospital time was significantly lower in group C as compared to group B (p<0.05). The onset time of sensory and motor blockade was significantly lower in group C as compared to group B (p<0.005). The duration of sensory and motor blockade was significantly less in group C as compared to group B (p<0.005). The time for unaided voiding and ambulation was less in group C as compared to group B. The need for an overnight stay was only needed in group B. The incidence of PONV and urinary retention was higher in group B. Conclusion In URSL surgery, the use of intrathecal 1% isobaric chloroprocaine 40 mg resulted in a reduced hospital stay time as compared to the use of intrathecal 10 mg of 0.5% isobaric bupivacaine. Also, it resulted in a significantly faster onset and faster regression of the block, less duration of the blockade, shorter time to ambulation and micturition, and a requirement for an overnight stay when compared with isobaric spinal bupivacaine.

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A randomized double blind study to compare 1% 2-chloroprocaine and 0.5% hyperbaric bupivacaine in spinal anesthesia for infra-umbilical surgeries

Cited by 6 publications

References 16 publications

Comparison of 0.5% hyperbaric bupivacaine versus 1% chloroprocaine in spinal anaesthesia in day care surgeries

Comparison of 0.5% hyperbaric bupivacaine versus 1% chloroprocaine in spinal anaesthesia in day care surgeries

Comparison of Levobupivacaine With Two Different Adjuvants (Dexamethasone vs. Dexmedetomidine) in Ultrasonography-Guided Transversus Abdominis Plane Block for Unilateral Inguinal Herniorrhaphy: A Randomized Double-Blinded Control Trial

A Comparative Study of Isobaric 1% Chloroprocaine With 0.5% Isobaric Bupivacaine for Ureteroscopic Lithotripsy Under Spinal Anaesthesia: A Prospective Randomised Study

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