Comparative study between 2-chloroprocaine and combination of 2-chloroprocaine with fentanyl for spinal anaesthesia

Abstract

Using fentanyl as an adjuvant in spinal anesthesia has well been documented. Fentanyl being an opioid additive prolongs the duration of neuroaxial blockade without significantly increasing the time to ambulation. Aim: To assess the effect of fentanyl as an adjuvant used with 2-chloroprocaine on sensory and motor onset and offset block time, time for ambulation and complication rate. Methodology: A randomized comparative study was conducted for a period of 6 months in the department of anesthesiology at Kirupananda Variyar medical college and hospital, Salem. A total of 100 patients (50 in each group) posted for elective surgeries in the age group between 20 and 60 were enrolled as our study subjects. Group A patients received intrathecal injection of 3 mL of 1% 2-Chloroprocaine (30 mg) mixed with 0.5 mL of Normal saline and Group B patients received 3 mL of 1% 2-Chloroprocaine (30 mg) mixed with 0.5 mL of Fentanyl solution containing 50 micrograms per mL (25 mcg). Bilateral sensory and motor block onset and regression time was monitored. Results: Time for regression of sensory block, recovery of motor block and time to void urine was comparatively more among group B (2-chloroprocaine with fentanyl) than group A (2-chloroprocaine) and the difference was found to be statistically significant (p < .05). The length of stay in post-anesthesia ICU and the patient satisfaction score did not show a statistical significant difference between the two groups. Similarly no change was noted in hemodynamic parameters and in the incidence of adverse events. Conclusion: We conclude that the addition of fentayl to 2 chloroprocaine has a significant synergistic effect in prolonging postoperative analgesia without prolonging the time for ambulation.