Comparison of epidural anesthesia with chloroprocaine and lidocaine for outpatient knee arthroscopy

Abstract

This study aimed to compare clinical efficacy and safety of chloroprocaine and lidocaine in epidural anesthesia for outpatient knee arthroscopy. Eighty patients undergoing knee arthroscopy were randomly allocated to receive 3% 2-chloroprocaine (group C, n = 40) or 2% lidocaine (group L, n = 40) for epidural block. Latency to anesthesia onset, highest block level, time to achieve peak effect, time to complete sensory and motor block regression, vital signs including respiration and hemodynamics, and complications during follow-up were recorded. No significant differences were found in the latency to anesthesia onset and peak effect, duration of anesthesia efficacy, and the time for recovery of sensory function between the two groups. However, the latency to maximal block of pain sensation and the time needed to recover motor function were significantly shorter in group C than in group L ( p < 0.05). No adverse effects or neurologic complications were found in both groups. In conclusion, epidural chloroprocaine elicits rapid anesthetic effects, fast sensor and motor block, and faster recovery of motor function compared to lidocaine. These characteristics make chloroprocaine better than lidocaine as the choice of epidural anesthesia in short clinical operations such as knee arthroscopy.

Chloroprocaine for Spinal or Epidural Anesthesia

“…Of the 14 peer-reviewed publications [2][3][4]6,[15][16][17][18][19][20][21][22][23][24] that met the selection criteria for this report, 11 were RCTs� 4,6,[15][16][17][18][19][20][22][23][24] The other 3 publications were SRs consisting of 1 SR with NMA based on a graph theoretical approach within a frequentist framework for indirect and mixed comparisons, 3 1 SR with NMA using Bayesian statistical analysis for direct and indirect comparisons, 21 and 1 SR with MA using a random effect model for statistical analysis� 2…”

“…Following the screening of titles and abstracts, 79 citations were excluded and 14 potentially relevant articles from the electronic search were retrieved for full-text review. No potentially relevant publication was identified from the grey literature search for full-text review� Fourteen publications [2][3][4]6,[15][16][17][18][19][20][21][22][23][24] met the selection criteria and were included in this report� Appendix 1 presents the PRISMA 25 flow chart of the study selection. Additional references of potential interest are provided in Appendix 5�…”

“…Fourteen peer-reviewed publications [2][3][4]6,[15][16][17][18][19][20][21][22][23][24] including 2 SRs with NMA, 3,21 1 SR with MA, 2 and 11 RCTs 4,6,[15][16][17][18][19][20][22][23][24] were included in this report� Given the diversity of the 3 included SRs in terms of population, intervention, comparator, and outcome (i�e�, PICO components), except for 1 RCT included in 2 SRs, 2,3 no more overlaps were identified in the 3 SRs. 2,3,21 Additional details regarding the characteristics of the included publications are provided in Appendix 2 (Table 2 and Table 3)�…”

“…Eleven RCTs 4,6,[15][16][17][18][19][20][22][23][24] were conducted by authors from India, 4,6,16,18,20,22,23…”

Anestesia neuroaxial en cirugía ambulatoria hoy: revisión de la literatura

“…Sin embargo, puede aumentar el tiempo de preparación del paciente antes de poder iniciar el procedimiento quirúrgico, lo que debemos tener en cuenta en cirugía ambulatoria para lograr una buena eficiencia del uso del pabellón.En un estudio que comparó anestesia general, peridural y espinal para artroscopía de rodilla, se observó que los tiempos de alta de las dos primeras era similar, y el alta de los pacientes con anestesia espinal era más tardía y con mayor incidencia de efectos adversos(42). La aparición de los anestésicos locales de duración corta como cloroprocaína (43),. ha demostrado que la anestesia peridural es también una buena alternativa en cirugías como la artroscopia de rodilla ambulatoria, facilitando altas más precoces en comparación a otros anestésicos locales.Por lo tanto, la anestesia peridural es una técnica que debemos mantener dentro de nuestras opciones de anestesias ambulatorias, pero teniendo en consideración las variables del procedimiento en sí y facilitando los tiempos de recuperación mediante el uso de anestésicos locales de duración corta.…”