68 1% Chloroprocaine spinal anesthesia for short duration surgical procedures

Background and Aims While permitting complete surgical anesthesia, subarachnoid blocks for ambulatory surgery are underused because of risk for urinary retention and delayed recovery of motor functions [1]. 1% Chloroprocaine is a fast onset and offset drug, which allows rapid recovery [2]. We report our experience with different short-duration surgical procedures. Methods With the patients‘ consent, 60 short procedures were carried out under spinal anesthesia with 1% chloroprocaine, with a 27 pencil-point needle; different injection levels and dosages were used achieving different results. Data regarded: type of procedures and duration; heart rate, blood pressure; pain; block level and Bromage score trends; complications. Results Procedures: urologic n. 15; hysteroscopy n. 8; foot n. 11; hernia n. 12; knee arthroscopy and stem cell treatment n.7; pilonidal cyst n. 2; liposuction n.5. Durations ranged between 15 and 80 minutes. Higher dosages (40–50 mg) lead to a decrease in blood pressure and heart rate when the injection level was L1-L2 or higher. IV Atropine avoids or restores physiologic heart rate. With lithotomy position, hypotension occurred less frequently. No patient experienced pain, with one exception of a hysteroscopy which received 30 mg at L2-L3 interspace. No complications were recorded. Levels and Bromage trends are displayed in table 1. Conclusions Spinal anesthesia with 1% chloroprocaine is a valid technique for short surgeries. From our experience, we may assume that 35–40 mg administered between T12 and L2 provide a reliable block up to T9-T10 lasting 40 minutes and regressing within 90 minutes, without significant hemodynamic changes. Research trials are needed to confirm our data.