Spinal 2-chloroprocaine: effective dose for ambulatory surgery

Area of Science:

• Anesthesiology
• Pharmacology
• Surgical Procedures

Background:

• Ambulatory surgery requires safe, short-acting spinal anesthetics.
• Evaluating plain 2-chloroprocaine (2-CP) for lower limb surgeries like knee arthroscopy and saphenectomy.

Purpose of the Study:

• Determine the effective dose of plain 2-chloroprocaine for spinal anesthesia in ambulatory lower limb surgery.
• Assess the safety and efficacy of varying doses of 2-CP.

Main Methods:

• Prospective, double-blind study involving 64 ASA physical status I-III patients.
• Patients received 35, 40, 45, or 50 mg of 10 mg/ml isobaric 2-CP via spinal anesthesia.
• Random allocation to four treatment groups (n=16 per group).

Main Results:

• All doses provided sufficient anesthesia for surgery with similar peak block heights (T9).
• Lower doses (35 and 40 mg) showed significantly faster sensory block regression and home discharge times compared to 50 mg.
• No spinal anesthesia complications or transient neurologic symptoms (TNS) were reported.

Conclusions:

• Spinal 2-CP at doses of 35-50 mg ensures reliable sensory and motor block for ambulatory surgery.
• Doses of 35 and 40 mg 2-CP accelerate patient ambulation and discharge.
• Plain 2-CP is a viable option for ambulatory spinal anesthesia.