Chloroprocaine vs. articaine as spinal anaesthetics for day-case knee arthroscopy

Förster, J. G.; Kallio, H.; Rosenberg, P. H.; Harilainen, Arsi; Sandelin, Jerker; Pitkänen, M.

doi:10.1111/j.1399-6576.2010.02325.x

Cited by 33 publications

(24 citation statements)

References 11 publications

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“…Studies comparing spinal anesthesia with low-dose bupivacaine and clinically comparable doses of 2-chloroprocaine in open inguinal hernia repair are still missing. However, studies in knee arthroscopy patients indicate that although the duration of the block is even slightly shorter than that caused by articaine [17] spontaneous voiding does not seem to occur significantly earlier after chloroprocaine (median 180 min) [18] than after low-dose bupivacaine in our present study (median 190 min).…”

Section: Discussioncontrasting

confidence: 70%

Randomized comparison of the feasibility of three anesthetic techniques for day-case open inguinal hernia repair

Péré

Harju

Kairaluoma

et al. 2016

Journal of Clinical Anesthesia

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Study objective: Comparison of local anesthetic infiltration (LAI), spinal anesthesia (SPIN) and total intravenous anesthesia (TIVA) for open inguinal herniorrhaphy. We hypothesized that patients receiving LAI could be discharged faster than SPIN and TIVA patients. Design: Randomized, prospective trial. Setting: University hospital day-surgery center. Patients: 156 adult male patients (ASA 1-3) undergoing day-case open inguinal herniorrhaphy. Interventions: Patients were randomized to either LAI (lidocaine + ropivacaine), SPIN (bupivacaine + fentanyl) or TIVA (propofol + remifentanil). Perioperative Ringer infusion was 1.5 mL/h. Urinary bladder was scanned before and after surgery. Interviews were performed on postoperative days 1, 7 and 90. Measurements: Duration of surgery, duration of the patients' stay in the operating room and time until their readiness for discharge home. Patient satisfaction and adverse effects were registered. Main results: Surgery lasted longer in LAI group (median 40 min) than in SPIN group (35 min) (P = .003) and TIVA group (33 min) (P b .001). Although surgery was shortest in TIVA group, TIVA patients stayed longer in the operating room than LAI patients (P = .001). Time until readiness for discharge was shorter in LAI group (93 min) than in TIVA (147 min) and SPIN (190 min) groups (P b .001). Supplementary lidocaine infiltration was given to 32 LAI patients, and IV fentanyl to 29 LAI and 4 SPIN patients. Ephedrine was required in 34 TIVA, 5 LAI and 5 SPIN patients. One SPIN and three LAI patients had to be given TIVA and another SPIN patient LAI to complete the operations. Urinary retention was absent. Discomfort in the scar (26%) three months postoperatively was not anesthesia-related. Conclusions: Logistically, LAI was superior because of the fastest recovery postoperatively. The anesthetic techniques were adequate for surgery in all but a few LAI and SPIN patients. Lack of urinary retention was probably related to the small IV infusion volumes.

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Section: Discussioncontrasting

confidence: 70%

Randomized comparison of the feasibility of three anesthetic techniques for day-case open inguinal hernia repair

Péré

Harju

Kairaluoma

et al. 2016

Journal of Clinical Anesthesia

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“…However, more studies are needed to establish the safety profile of chloroprocaine in spinal anesthesia. [34]…”

Section: Pharmacologymentioning

confidence: 99%

Use of Articaine in loco-regional anesthesia for day care surgical procedures

Bajwa

Jindal

2012

J Anaesthesiol Clin Pharmacol

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The popularity of day case surgical procedures has increased immensely over the last few years. Though various techniques are available for carrying out day-case anesthesia, preference for a technique depends upon the type of procedure, patient profile, associated co-morbidities, available infrastructure and back-up facilities, monitoring devices and comfort of the attending anesthesiologist with the technique. Day-case spinal anesthesia for ambulatory surgery has gained a wider acceptance and numerous drugs are available for use in loco-regional anesthesia. Articaine is one such amide local anesthetic drug which is increasingly being used in day care surgeries. Properties of articaine such as faster onset, shorter elimination time and rapid recovery from sensory and motor blockade make it a very useful agent in local and regional anesthesia for day care surgical procedures. This article aims to review these properties of articaine so as to evaluate how useful articaine can be for ambulatory surgical procedures.

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“…38–40 Mutual comparison of these four local anesthetics showed no evident significant clinical advantages for any over another. The results of the articaine groups are shown in Table 1, with the caveat that the designs of the studies were quite different, as were the dosages and concentrations used: articaine (1.25 mg/kg and 80 mg, 5% with glucose 10%) versus lidocaine9,41; articaine (50 mg, 2% plain) versus prilocaine; 42 articaine (60 mg, 2% plain) versus chloroprocaine 43. Other studies have investigated different articaine solutions or articaine with glucose versus bupivacaine; spinal blockade characteristics are displayed in Table 2 38,44–46…”

Section: Therapeutic Efficacymentioning

confidence: 99%

“…All local anesthetics are potentially neurotoxic, and so is articaine. The incidence of nerve damage with intrathecal articaine appears to be low 38,41–43,45,46. Articaine at low concentrations (2%–3%), with or without glucose, has been demonstrated to be very suitable for spinal anesthesia in day-care patients for lower limb surgery, wherein discharge criteria might be met rapidly 45…”

Section: Therapeutic Efficacymentioning

confidence: 99%

Articaine: a review of its use for local and regional anesthesia

Snoeck¹

2012

LRA

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Articaine is an intermediate-potency, short-acting amide local anesthetic with a fast metabolism due to an ester group in its structure. It is effective with local infiltration or peripheral nerve block in dentistry, when administered as a spinal, epidural, ocular, or regional nerve block, or when injected intravenously for regional anesthesia. In comparative trials, its clinical effects were not generally significantly different from those of other short-acting local anesthetics like lidocaine, prilocaine, and chloroprocaine, and there is no conclusive evidence demonstrating above-average neurotoxicity. Articaine proved to be suitable and safe for procedures requiring a short duration of action in which a fast onset of anesthesia is desired, eg, dental procedures and ambulatory spinal anesthesia, in normal and in special populations.

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Chloroprocaine vs. articaine as spinal anaesthetics for day-case knee arthroscopy

Cited by 33 publications

References 11 publications

Randomized comparison of the feasibility of three anesthetic techniques for day-case open inguinal hernia repair

Randomized comparison of the feasibility of three anesthetic techniques for day-case open inguinal hernia repair

Use of Articaine in loco-regional anesthesia for day care surgical procedures

Articaine: a review of its use for local and regional anesthesia

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