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Short-acting spinal anesthesia in the ambulatory setting
1Department of Anesthesiology, Orthopedic Hospital Orton, Helsinki, Finland.
Current Opinion in Anaesthesiology
|September 12, 2014
Summary
Short-acting local anesthetics like articaine, chloroprocaine, and prilocaine show promise for ambulatory spinal anesthesia, offering fast onset and quick recovery with rare side effects. Further research will clarify their roles in different procedures and economic impacts.
Area of Science:
- Anesthesiology
- Pharmacology
Background:
- Renewed interest in short-acting local anesthetics for ambulatory spinal anesthesia.
- Potential clinical and economic benefits drive this interest.
Purpose of the Study:
- Review current advances (1-2 years) in the use of articaine, chloroprocaine, and prilocaine for ambulatory spinal anesthesia.
- Evaluate their efficacy, safety, and economic aspects.
Main Methods:
- Literature search for relevant articles.
- Analysis of randomized controlled trials and other study designs.
Main Results:
- Articaine, chloroprocaine, and prilocaine demonstrated fast onset, effective block, and rapid recovery in trials.
- Transient neurologic symptoms were rare; guidelines for urinary retention were proposed.
- Unilateral spinal anesthesia and economic factors were also investigated.
Conclusions:
- Intrathecal articaine (off-label), chloroprocaine, and prilocaine are appealing options for ambulatory settings.
- Chloroprocaine suits shorter procedures; articaine and prilocaine may be better for longer ones.
- Further studies needed to compare these anesthetics and assess economic implications.
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