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Anesth Analg 2005;100:573-579
© 2005 International Anesthesia Research Society
doi: 10.1213/01.ANE.0000143380.36298.4A

REGIONAL ANESTHESIA

Spinal 2-Chloroprocaine: A Comparison with Procaine in Volunteers

Aaron F. Gonter, MD, and Dan J. Kopacz, MD

Department of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington

Recent studies using preservative-free 2-chloroprocaine (2-CP) for spinal anesthesia have shown it to be a reliable short-acting drug that provides similar anesthesia to lidocaine. In this randomized, double-blind, crossover study, we compared the characteristics of spinal 2-CP (30 mg) with those of procaine (80 mg) in eight volunteers to determine whether either drug produces spinal anesthetic characteristics ideal for outpatient surgery. By using sensation to pinprick, transcutaneous electrical stimulation, tolerance to thigh tourniquet, and motor blockade as surrogates for surgical efficacy, 2-CP compared similarly to procaine. Peak block height (T9 [range, T6 to T12] versus T6 [T4 to T8]; P = 0.0796), time to two-segment regression (51 ± 17 min versus 53 ± 10 min; P = 0.7434), tourniquet time tolerance (37 ± 16 versus 49 min ± 17 min; P = 0.1755), and time to return of motor strength (Bromage scale: 54 ± 23 min versus 55 ± 44 min, P = 0.9366; return of 90% quadriceps strength: 78 ± 9 min versus 98 ± 30 min; P = 0.0721) were all similar. Procaine did produce overall longer sensory blockade (P = 0.0011) and motor blockade at the gastrocnemius (P = 0.0004) and quadriceps (P = 0.0146) muscles. Times until the resolution of sensory blockade (103 ± 12 min versus 151 ± 26 min; P = 0.0003), ambulation (103 ± 12 min versus 151 ± 26 min; P = 0.0003), and micturition (103 ± 12 min versus 156 ± 23 min; P < 0.0001) were all prolonged after procaine. In conclusion, at the doses tested, spinal 2-CP (30 mg) may be a better choice for short outpatient procedures because it provides anesthesia with similar efficacy as procaine (80 mg) but with more rapid fulfillment of discharge criteria.




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K. Drasner
Chloroprocaine Spinal Anesthesia: Back to the Future?
Anesth. Analg., February 1, 2005; 100(2): 549 - 552.
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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 2005 by the International Anesthesia Research Society.