Comparison of Two Doses of Chloroprocaine for Spinal Anaesthesia in Brachytherapy Procedures: A Randomised Clinical Study

Abstract

Introduction: Subarachnoid block is a widely used anaesthetic technique for lower abdominal and lower limb surgeries. Commonly used local anaesthetics are with longer duration of action and delayed recovery. Chloroprocaine is good choice for day care procedures because of its reliable action, faster resolution of block and earlier discharge time. Aim: To compare the minimum effective dose of chloroprocaine for spinal anaesthesia in brachytherapy. Materials and Methods: A total of 140 carcinoma cervix patients of ASA class I and II of age group 18 to 60 years were randomly divided into two groups of 70 each. They were posted for elective brachytherapy procedure under subarachnoid block. Group A patients received 2 mL of chloroprocaine (20 mg) and Group B patients received 3 mL of chloroprocaine (30 mg). Parameters like onset of sensory and motor blocks, maximum level of sensory block, time for two segment regression, duration of block and haemodynamic parameters were studied for the duration of procedure. Data were analysed using SAS 9.2, SPSS 15.0 software version. Descriptive and inferential statistical analysis was carried out. Results on continuous measurements are presented as mean±SD (min-max) and results on categorical measurements are presented in number (%). Significance was assessed at 5% level of significance. Results: Patients in both the groups were comparable with respect to the demographic characteristics. There were statistically significant differences in time for onset of motor blockade, duration of motor and sensory blockade, time for two segment regression which were shorter in chloroprocaine 20 mg (group A) compared to chloroprocaine 30 mg (group B). Haemodynamic variations and incidence of side-effects were similar in both groups. Conclusion: Subarachnoid 2-chloroprocaine (30 mg) provides adequate duration and density of spinal anaesthesia for brachytherapy procedures as compared with 20 mg 2-chloroprocaine.