The effect of different doses of chloroprocaine on saddle anesthesia in perianal surgery

Zhang, Ying; Yang, Bo; Li, Linggeng; Shi, Dinghua

doi:10.1590/s0102-86502014000100010

Cited by 10 publications

(10 citation statements)

References 15 publications

(8 reference statements)

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“…The results were similar to study performed by Zhang Y et al in 2014. 17 Though duration of surgery was not affected by amount of drug used in present study, 10 mg dose causes early post operative pain while 30 mg dose causes delayed unassisted ambulation and urinary voiding postoperatively so 15 mg dose can be used as optimal dose to avoid limitations of 10mg and side effects of 30 mg dose.…”

Section: Discussionmentioning

confidence: 61%

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The effect of different doses of chloroprocaine 1% for low dose saddle anaesthesia in outpatient perianal surgery: A prospective randomized study

Jain¹

2021

IJCA

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The present study was designed to investigate saddle anesthesia with different doses of chloroprocaine at the same concentration (0.5%, w/v) in terms of extent of sensory and motor block, recovery from block, time for ambulation and time for urinary voiding. The study was conducted in the department of Anaesthesiology of a tertiary healthcare centre of southern Rajasthan. 120 patients of either sex, aged between 20-50 years, with American Society of Anaesthesiologists grade I/II scheduled for elective perianal surgery in lithotomy position (duration < 40 minutes), were enrolled in the study. The patients were divided into three groups (n=40/group), receiving either 10mg, 15mg or 20mg of 1% 2-chloroprocaine in saddle anaesthesia. The effect was noted and compared in terms of extent of sensory and motor block, recovery from block, time for ambulation and time for urinary voiding. All the three groups were comparable with no statistical difference in terms of age, weight, height, BMI, ASA grading and site of injection among the participants of the groups. Number of patients who were able to move from stretcher to operation table and again from operation table to stretcher without help did not differ significantly among all the three groups. Similarly, there was no statistically significant difference in pre operative and post operative Bromage scores of participants among three groups (p value > 0.05). There was significant difference in the number of anaesthetized dermatomes both pre and post operatively among all the three groups (p value <0.001). Duration of surgery did not differ significantly among the three groups. There was also significant diference in the time for unassisted ambulation post operatively and time for urinary voiding among the three groups (p value < 0.001). 10 mg chloroprocaine may cause early post operative pain while 30 mg dose may cause delayed unassisted ambulation and urinary voiding postoperatively so 15 mg dose can be used as minimum optimal dose for saddle anaesthesia for ultra-short perianal procedures.

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Section: Discussionmentioning

confidence: 61%

“…A total of 120 patients (40 in each group) were calculated at 80% power and type 1 error pf 0.05 using sensory and motor blockage as primary outcome measure from a previous study done by Ying Zhang et al using different dosesof chloroprocaine on saddle anaesthesia in perianal surgeries. 17…”

Section: Sample Sizementioning

confidence: 99%

The effect of different doses of chloroprocaine 1% for low dose saddle anaesthesia in outpatient perianal surgery: A prospective randomized study

Jain¹

2021

IJCA

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“…[2,3] Saddle block provides an acceptable hemodynamic stability and a high degree of success rate. [4] The extension and duration of motor blockade should be followed. Caudal block is widely used both in adult and pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

Regional anesthesia for anorectal Surgeries: what is the best solution?

Şimşek¹

2021

South Clin Ist Euras

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Objective: Different regional anesthesia techniques are used in anorectal surgeries. The ideal anesthetic method should provide adequate analgesia, patient comfort and safety, and enable early mobilization. The aim of this study was to compare the effects of caudal block and saddle block techniques on post-operative analgesic consumption, number of patients requiring analgesic agent, and initial analgesic requirement. Methods:The current study included 71 patients undergoing elective anorectal surgery. In the saddle block group, we inserted 25 G Quincke spinal needle by the ultrasonography guidance into the intrathecal space at L4-L5 level and administered 7.0 mg hyperbaric bupivacaine. In the caudal block group, we inserted 20 G caudal needle by ultrasound guidance into the epidural space at S4-S5 level and administered 25 ml bupivacaine at a concentration of 0.5%. Results:In group caudal, post-operative analgesic consumption and number of patients requiring analgesic agent were significantly lower than group saddle (p<0.05). In group saddle, first analgesic requirement time was significantly lower than group caudal (p<0.05). Conclusion:In this study, significantly better results were obtained in group caudal regarding post-operative analgesic consumption, number of patients requiring analgesic agent, and initial analgesic requirements time. We concluded that caudal block can be more efficient for anorectal surgery in clinical practice.

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“…Chloroprocaine was re-introduced without antioxidant and preservatives, which can be used safely in spinal anesthesia. It is a good alternative local anaesthetic to mediumacting (Lidocaine) and long-acting local anaesthetics (Bupivacaine) for outpatient spinal anaesthesia [2] .…”

Section: Introductionmentioning

confidence: 99%

Low dose spinal with chlorprocaine a prospective observational study

Deusecar¹,

Bv²

2021

Int. J. Med. Anesthesiology

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Low-dose spinal saddle anaesthesia is a safe and reliable anaesthesia technique in outpatient perianal surgery, which provides a reliable but restricted block with good surgical conditions. Chloroprocaine was re-introduced without antioxidant and preservatives, which can be used safely in spinal anesthesia. Fentanyl is an opiod agonist, acts on mu receptor and of addition of fentanyl to chlorprocaine appears to lengthen the regression to L1 dermatome while minimally lengthening duration of block. This study was done to compare the effects of two different doses of fentanyl as an adjuvant to 1% Chloroprocaine under saddle block for perianal surgeries, and duration of stay in hospital. Materials and Methods:The study was a randomized controlled double blinded trial conducted on 45 patients aged between 18 -65 years (ASA 1 and 2) posted for perianal surgeries under spinal anaesthesia in private hospitals in and around Dakshina Kannada from January 2018 to June 2021. The groups are assigned as follows: Group A (n = 15) received1% Chloroprocaine 20 mg plus 0.5 ml of normal saline intrathecally. Group B (n = 15) received1% Chloroprocaine 20mg plus fentanyl 15 µg (0.3ml) + 0.2ml of normal saline intrathecally. Group C (n = 15) received1% Chloroprocaine 20 mg plus fentanyl 25 µg (0.5ml) intrathecally. The sensory block, modified bromage scale, post operatively analgesia duration and the rescue analgesia patient's and surgeon's satisfaction score, side effects were noted. Observations and Results: There was no significant difference in the maximum Bromage score for the motor block it was 11.57 seconds in Group and Group B and 11. 11.6 in group C . NRS score that denotes the quality of analgesia was higher in group A indicating that the satisfaction was lesser .In the group A the time was the longest followed by group B and group C had the least two segment sensory regression time and was statistically significant with a p value< 0.05. In our study in the group A the time for motor regression to baseline was the highest followed by group C and group B had the least time for the motor regression to baseline and was statistically significant with a p value < 0.05.group A required the highest number of analgesia doses followed by group B and group C required equal number of analgesia and was statistically significant with a p value < 0.05. Group A had the least patient and surgeon satisfaction scores followed by group B and group C had the maximum time and was statistically significant with a p value < 0.05. Conclusion: Group B had better hemodynamic parameters than group A and group C . Group C was associated with a lot of adverse event intra op like hypotension and group A had a higher need of analgesic and faster sensory loss Hence, considering the nature and duration of the procedure, low dose saddle block anaesthesia with 2-Chloroprocaine would be a suitable choice and we evaluated the drug in varying doses to study the clinical response of varying doses, for procedures lasting for small duration 20 mg is sufficient, the...

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The effect of different doses of chloroprocaine on saddle anesthesia in perianal surgery

Cited by 10 publications

References 15 publications

The effect of different doses of chloroprocaine 1% for low dose saddle anaesthesia in outpatient perianal surgery: A prospective randomized study

The effect of different doses of chloroprocaine 1% for low dose saddle anaesthesia in outpatient perianal surgery: A prospective randomized study

Regional anesthesia for anorectal Surgeries: what is the best solution?

Low dose spinal with chlorprocaine a prospective observational study

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