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Chloroprocaine and lidocaine decrease hospital stay and admission rate after outpatient epidural anesthesia
1Department of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington 98111.
Regional Anesthesia
|January 1, 1990
Summary
For outpatient surgery like ESWL, 2-chloroprocaine and lidocaine offer shorter recovery than mepivacaine. Mepivacaine resulted in longer anesthesia and discharge times, suggesting it may not be ideal for ambulatory epidural anesthesia.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Outpatient surgical procedures require local anesthetics with predictable and short recovery times.
- The choice of local anesthetic impacts patient discharge and potential for unplanned admissions.
Purpose of the Study:
- To compare the duration of sensory anesthesia and recovery times for 2-chloroprocaine, lidocaine, and mepivacaine in outpatient epidural anesthesia.
- To evaluate the suitability of these agents for ambulatory procedures like extracorporeal shock wave lithotripsy (ESWL).
Main Methods:
- A randomized study involving 84 outpatients undergoing ESWL.
- Administration of lumbar epidural anesthesia using 20 ml of 3% 2-chloroprocaine, 1.5% lidocaine, or 1.5% mepivacaine, all with epinephrine.
- Measurement of sensory anesthesia duration and time to patient discharge.
Main Results:
- Mepivacaine produced significantly longer sensory anesthesia (247 min) compared to 2-chloroprocaine (133 min) and lidocaine (182 min) (p < 0.05).
- Time to discharge was significantly longer with mepivacaine (357 min) versus 2-chloroprocaine (269 min) and lidocaine (284 min).
- A trend suggested increased overnight admission rates with longer-acting anesthetics.
Conclusions:
- Continuous epidural anesthesia with 2-chloroprocaine, lidocaine, or mepivacaine is safe and effective for outpatient ESWL.
- Mepivacaine's prolonged anesthesia and recovery times indicate it may be suboptimal for outpatient epidural anesthesia compared to shorter-acting agents.