Spinal chloroprocaine may be more suitable for day-case surgery than lignocaine because of faster block resolution and time to discharge.

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• M B Breebaart, A Teune, L A Sermeus, and M P Vercauteren.
• Acta Anaesthesiol Scand. 2014 Feb 1;58(2):206-13.

BackgroundThis randomised, double blind prospective study compares intrathecal lidocaine with chloroprocaine in day-case surgery and the influence of a 500 ml pre-load intravenously. We tested the hypothesis that chloroprocaine provides faster recovery and discharge in day-case surgery. Secondary we studied the influence of a preload compared with fluid restriction on discharge time and micturition problems.MethodsOne hundred patients undergoing day-case arthroscopy were randomised to receive either lidocaine (L) 60 mg or chloroprocaine (CP) 40 mg intrathecally and this with (L+, CP+) or without (L−, CP−) a 500 ml pre-load of crystalloid. Block characteristics, micturition and discharge times were registered. Bladder volumes were monitored by ultrasound. Micturition problems received a micturition score.ResultsOnset and quality of the block were comparable between groups. Time to regain Bromage 1 and L2 regression were shorter for the CP group compared with the L group. Voiding (168 ± 44 min) and discharge (178 ± 52 min) were approximately 40 min faster for the CP group compared with the L group. Pre-load provided faster bladder filling but there were no differences in voiding time within the CP or L group. The CP+ group (166 ± 36 min) was discharged faster than both L groups (226 ± 57 min, 227 ± 59 min). More serious micturition problems occurred in the L+ group compared with both CP groups.ConclusionChloroprocaine is suitable for day-case surgery because of faster block regression and discharge than lidocaine. A 500 ml pre-load may not affect discharge but did not increase micturition problems for chloroprocaine.

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