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Anesth Analg 2004;98:70-74
© 2004 International Anesthesia Research Society

AMBULATORY ANESTHESIA

Spinal Chloroprocaine Solutions: Density at 37° C and pH Titration

Kimberly B. Na, MD, and Dan J. Kopacz, MD Section Editor

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

Address correspondence to Dr. Kopacz, Department of Anesthesiology, Virginia Mason Medical Center, 1100 Ninth Avenue, B2-AN, PO Box 900, Seattle, WA 98111. Address email to anedjk{at}vmmc.org

The density and pH of a local anesthetic are important characteristics in its use as an intrathecal drug. Preservative- and antioxidant-free formulations of chloroprocaine are available and are being investigated for short-duration spinal anesthesia. In this study, we evaluated the pH and density (to 5 significant digits in g/mL, at 37.0°C) of these new chloroprocaine formulations. In addition to plain 2% and 3% chloroprocaine and 2% lidocaine, mixed solutions of 2% chloroprocaine with epinephrine or with bicarbonate were evaluated. Density was also measured after water dilution and after increasing amounts of added dextrose. Chloroprocaine, 2% or 3%, is hyperbaric relative to cerebrospinal fluid (CSF) before any addition of dextrose (density 1.00123 g/mL and 1.00257 g/mL, respectively). When diluted with water, all the solutions are hypobaric relative to CSF (density <1.00028 g/mL). Plain 2% lidocaine is the only dextrose-free solution measured to be hypobaric (density 1.00004 g/mL). Bisulfite-free 2-chloroprocaine remains very acidic (pH <4.0), but the pH can be increased to more than 7.0 with a small amount of bicarbonate (0.25–0.33 mL/10 mL). The increased density of plain chloroprocaine makes it a useful hyperbaric spinal drug without the addition of dextrose.

IMPLICATIONS: Dextrose-free 2-chloroprocaine is hyperbaric relative to cerebrospinal fluid at 37°C, and therefore can be used for spinal anesthesia without dextrose. Bisulfite-free 2-chloroprocaine remains very acidic (pH <4.0). The pH can be increased to more than 7.0 with a small amount of bicarbonate (0.25–0.33 mL/10 mL).




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 Anesth. Analg.Home page
J. R. Yoos and D. J. Kopacz
Spinal 2-Chloroprocaine: A Comparison with Small-Dose Bupivacaine in Volunteers
Anesth. Analg., February 1, 2005; 100(2): 566 - 572.
[Abstract] [Full Text] [PDF]


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 © 2004 by the International Anesthesia Research Society.