Comparison of Chloroprocaine and Bupivacaine for Spinal Anaesthesia in Patients Undergoing Day Care Surgery: A Double Blind Randomized Controlled Study

Abstract

Background:In the last few years, the number of surgical procedures performed on day care basis has increasedworldwide, nearly between 20% - 30% surgeries are being performed as outpatient procedures. Ambulatorysurgery has become increasingly popular due to advantages for the individual patient and the positive economicimpact for the health care system. In the near future, ambulatory surgery is likely to expand further.Objectives: The objectives of this study were to compare chloroprocaine and bupivacaine for spinal anaesthesia inpatients undergoing day care surgery.Methods: Patients between 18-60 years’ age of either sex, belonging to ASA I and ASA II undergoing day caresurgeries lasting 45-60 min were included in this study after approval of Institutional Review Board and obtaininginformed consent. Preanaesthetic check-up was done one day before surgery patients were evaluated for anysystemic diseases and laboratory investigation recorded the procedure of spinal anaesthesia was explained tothe patients and written informed consents was obtained. Hundred patients were randomly divided into twogroups of fifty each. Fifty patients received 0.5% heavy 10mg (2cc) bupivacaine. Fifty patients received 40mg (4cc)preservative free 2-chloroprocaine. The primary outcome of this study, I. e., the time to eligibility for dischargefrom hospital, was measured from the time spinal anaesthesia was performed to the time the patient attained allof the discharge criteria.Results : Intrathecal 1% 2-chloroprocaine 40 mg provides spinal anaesthesia of adequate duration for day caresurgeries with the advantage of earlier onset and faster regression of spinal block resulting in earlier ambulationand earlier voiding with stable hemodynamic as compared to 0.5% hyperbaric bupivacaine 10 mg. Conclusion: Thus we conclude that 2-chloroprocaine can provide spinal anaesthesia with a shorter recoveryprofile than bupivacaine, permitting earlier discharge from hospital after day care surgeries