Chloroprocaine versus prilocaine for spinal anesthesia in ambulatory knee arthroscopy: a double-blind randomized trial

Elsbeth Wesselink, Godelief Janssen-van den Hurk, Rien van der Vegt, Cornelis Slagt, Jan van der Aa, Eric Franssen, Peter van de Ven, Noortje Swart, Christa Boer, Marcel de Leeuw

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background In ambulatory lower limb surgery, spinal anesthesia with rapid onset and a short duration of block is preferable. We hypothesized that the use of 2-chloroprocaine would be associated with a faster motor block recovery compared with prilocaine in knee arthroscopy. A difference of 15 min was considered clinically relevant. Methods 150 patients were randomly allocated to receive intrathecally either 40 mg of 2-chloroprocaine or 40 mg of prilocaine. The primary outcome was the time to complete recovery from motor blockade. Secondary outcomes included time to full regression of sensory block, peak sensory block level, urine retention needing catheterization, time until hospital discharge, incidence of transient neurologic symptoms and patient satisfaction. Results Time to complete recovery from motor blockade was 15 min shorter for 2-chloroprocaine (median: 60 min; IQR: 60-82.5) than for prilocaine (median: 75 min; IQR: 60-90; p=0.004). 2-Chloroprocaine also resulted in faster full regression of sensory block (median: 120 min; IQR: 90-135 compared with median: 165 min; IQR: 135-190, p<0.001) and faster time to hospital discharge (mean difference: 57 min; 95% CI 38 to 77, p<0.001). Peak sensory block was higher in the 2-chloroprocaine group (median: T9; IQR: T6-T12 compared with median: T10; IQR: T8-T12, p<0.008). Patient satisfaction and urine retention needing catheterization were equal in both groups. Conclusions In knee arthroscopy, spinal anesthesia with 2-chloroprocaine results in a faster recovery of motor and sensory block, leading to quicker hospital discharge compared with prilocaine. Trial registration number NTR6796.

Original languageEnglish
Pages (from-to)944-949
Number of pages6
JournalRegional Anesthesia and Pain Medicine
Volume44
Issue number10
DOIs
Publication statusPublished - 1 Oct 2019

Cite this

Wesselink, Elsbeth ; Hurk, Godelief Janssen-van den ; Vegt, Rien van der ; Slagt, Cornelis ; Aa, Jan van der ; Franssen, Eric ; Ven, Peter van de ; Swart, Noortje ; Boer, Christa ; Leeuw, Marcel de. / Chloroprocaine versus prilocaine for spinal anesthesia in ambulatory knee arthroscopy: a double-blind randomized trial. In: Regional Anesthesia and Pain Medicine. 2019 ; Vol. 44, No. 10. pp. 944-949.
@article{6030e7d2744f4a06a45696f3bad7bf81,
title = "Chloroprocaine versus prilocaine for spinal anesthesia in ambulatory knee arthroscopy: a double-blind randomized trial",
abstract = "Background In ambulatory lower limb surgery, spinal anesthesia with rapid onset and a short duration of block is preferable. We hypothesized that the use of 2-chloroprocaine would be associated with a faster motor block recovery compared with prilocaine in knee arthroscopy. A difference of 15 min was considered clinically relevant. Methods 150 patients were randomly allocated to receive intrathecally either 40 mg of 2-chloroprocaine or 40 mg of prilocaine. The primary outcome was the time to complete recovery from motor blockade. Secondary outcomes included time to full regression of sensory block, peak sensory block level, urine retention needing catheterization, time until hospital discharge, incidence of transient neurologic symptoms and patient satisfaction. Results Time to complete recovery from motor blockade was 15 min shorter for 2-chloroprocaine (median: 60 min; IQR: 60-82.5) than for prilocaine (median: 75 min; IQR: 60-90; p=0.004). 2-Chloroprocaine also resulted in faster full regression of sensory block (median: 120 min; IQR: 90-135 compared with median: 165 min; IQR: 135-190, p<0.001) and faster time to hospital discharge (mean difference: 57 min; 95{\%} CI 38 to 77, p<0.001). Peak sensory block was higher in the 2-chloroprocaine group (median: T9; IQR: T6-T12 compared with median: T10; IQR: T8-T12, p<0.008). Patient satisfaction and urine retention needing catheterization were equal in both groups. Conclusions In knee arthroscopy, spinal anesthesia with 2-chloroprocaine results in a faster recovery of motor and sensory block, leading to quicker hospital discharge compared with prilocaine. Trial registration number NTR6796.",
keywords = "2-chloroprocaine hydrochloride, arthroscopy, knee, prilocaine, spinal anesthesia",
author = "Elsbeth Wesselink and Hurk, {Godelief Janssen-van den} and Vegt, {Rien van der} and Cornelis Slagt and Aa, {Jan van der} and Eric Franssen and Ven, {Peter van de} and Noortje Swart and Christa Boer and Leeuw, {Marcel de}",
year = "2019",
month = "10",
day = "1",
doi = "10.1136/rapm-2019-100673",
language = "English",
volume = "44",
pages = "944--949",
journal = "Regional Anesthesia and Pain Medicine",
issn = "1098-7339",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

Chloroprocaine versus prilocaine for spinal anesthesia in ambulatory knee arthroscopy: a double-blind randomized trial. / Wesselink, Elsbeth; Hurk, Godelief Janssen-van den; Vegt, Rien van der; Slagt, Cornelis; Aa, Jan van der; Franssen, Eric; Ven, Peter van de; Swart, Noortje; Boer, Christa; Leeuw, Marcel de.

In: Regional Anesthesia and Pain Medicine, Vol. 44, No. 10, 01.10.2019, p. 944-949.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Chloroprocaine versus prilocaine for spinal anesthesia in ambulatory knee arthroscopy: a double-blind randomized trial

AU - Wesselink, Elsbeth

AU - Hurk, Godelief Janssen-van den

AU - Vegt, Rien van der

AU - Slagt, Cornelis

AU - Aa, Jan van der

AU - Franssen, Eric

AU - Ven, Peter van de

AU - Swart, Noortje

AU - Boer, Christa

AU - Leeuw, Marcel de

PY - 2019/10/1

Y1 - 2019/10/1

N2 - Background In ambulatory lower limb surgery, spinal anesthesia with rapid onset and a short duration of block is preferable. We hypothesized that the use of 2-chloroprocaine would be associated with a faster motor block recovery compared with prilocaine in knee arthroscopy. A difference of 15 min was considered clinically relevant. Methods 150 patients were randomly allocated to receive intrathecally either 40 mg of 2-chloroprocaine or 40 mg of prilocaine. The primary outcome was the time to complete recovery from motor blockade. Secondary outcomes included time to full regression of sensory block, peak sensory block level, urine retention needing catheterization, time until hospital discharge, incidence of transient neurologic symptoms and patient satisfaction. Results Time to complete recovery from motor blockade was 15 min shorter for 2-chloroprocaine (median: 60 min; IQR: 60-82.5) than for prilocaine (median: 75 min; IQR: 60-90; p=0.004). 2-Chloroprocaine also resulted in faster full regression of sensory block (median: 120 min; IQR: 90-135 compared with median: 165 min; IQR: 135-190, p<0.001) and faster time to hospital discharge (mean difference: 57 min; 95% CI 38 to 77, p<0.001). Peak sensory block was higher in the 2-chloroprocaine group (median: T9; IQR: T6-T12 compared with median: T10; IQR: T8-T12, p<0.008). Patient satisfaction and urine retention needing catheterization were equal in both groups. Conclusions In knee arthroscopy, spinal anesthesia with 2-chloroprocaine results in a faster recovery of motor and sensory block, leading to quicker hospital discharge compared with prilocaine. Trial registration number NTR6796.

AB - Background In ambulatory lower limb surgery, spinal anesthesia with rapid onset and a short duration of block is preferable. We hypothesized that the use of 2-chloroprocaine would be associated with a faster motor block recovery compared with prilocaine in knee arthroscopy. A difference of 15 min was considered clinically relevant. Methods 150 patients were randomly allocated to receive intrathecally either 40 mg of 2-chloroprocaine or 40 mg of prilocaine. The primary outcome was the time to complete recovery from motor blockade. Secondary outcomes included time to full regression of sensory block, peak sensory block level, urine retention needing catheterization, time until hospital discharge, incidence of transient neurologic symptoms and patient satisfaction. Results Time to complete recovery from motor blockade was 15 min shorter for 2-chloroprocaine (median: 60 min; IQR: 60-82.5) than for prilocaine (median: 75 min; IQR: 60-90; p=0.004). 2-Chloroprocaine also resulted in faster full regression of sensory block (median: 120 min; IQR: 90-135 compared with median: 165 min; IQR: 135-190, p<0.001) and faster time to hospital discharge (mean difference: 57 min; 95% CI 38 to 77, p<0.001). Peak sensory block was higher in the 2-chloroprocaine group (median: T9; IQR: T6-T12 compared with median: T10; IQR: T8-T12, p<0.008). Patient satisfaction and urine retention needing catheterization were equal in both groups. Conclusions In knee arthroscopy, spinal anesthesia with 2-chloroprocaine results in a faster recovery of motor and sensory block, leading to quicker hospital discharge compared with prilocaine. Trial registration number NTR6796.

KW - 2-chloroprocaine hydrochloride

KW - arthroscopy

KW - knee

KW - prilocaine

KW - spinal anesthesia

UR - http://www.scopus.com/inward/record.url?scp=85071636992&partnerID=8YFLogxK

U2 - 10.1136/rapm-2019-100673

DO - 10.1136/rapm-2019-100673

M3 - Article

VL - 44

SP - 944

EP - 949

JO - Regional Anesthesia and Pain Medicine

JF - Regional Anesthesia and Pain Medicine

SN - 1098-7339

IS - 10

ER -