Document Detail


Selective spinal anesthesia for outpatient transurethral prostatectomy (TURP): randomized controlled comparison of chloroprocaine with lidocaine.
MedLine Citation:
PMID:  22236346     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: This is a study comparing two short-acting local anesthetics lidocaine and 2-chloroprocaine in combination with fentanyl, to provide selective spinal anesthesia for outpatient transurethral resection of the prostate (TURP).
METHODS: In this prospective, randomized double-blind study, selective spinal anesthesia was performed in 40 American Society of Anesthesiologists I-III outpatients undergoing TURP using either 40 mg of chloroprocaine mixed with 12.5 μg of fentanyl (n = 20) or 35 mg of lidocaine mixed with 12.5 μg of fentanyl (n = 20). The primary outcome was duration of spinal block. Secondary outcomes were time to reach T10 (onset), time to maximal level, duration above T10 and lidocaine 3, maximal level of block, and adverse effects.
RESULTS: The median (minimum, maximum) onset time was 4 (1, 16) and 3 (2, 10) min for chloroprocaine and lidocaine, respectively. Time to maximal level was 20 (17, 29) and 22 (16, 26) min for chloroprocaine and lidocaine, respectively. Mean maximal level was T7-T8 for both agents. Duration of block above T10 was 54 (28, 88) and 63 (31, 87) min for chloroprocaine and lidocaine, respectively. Duration of block above lidocaine 3 was 93 (56, 218) and 98 (58, 151) min for chloroprocaine and lidocaine, respectively. There was no statistical difference between the two groups with respect to these clinical end points. Four patients in the lidocaine group developed transient neurological symptoms. One patient in the chloroprocaine group developed a cauda equina-like syndrome but recovered fully after several weeks.
CONCLUSIONS: Selective spinal anesthesia with chloroprocaine and lidocaine for TURP yielded comparable results for clinical characteristics. Further research on transient neurological symptom and cauda equina risk with chloroprocaine is warranted.
Authors:
H Vaghadia; G Neilson; P H Lennox
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta anaesthesiologica Scandinavica     Volume:  56     ISSN:  1399-6576     ISO Abbreviation:  Acta Anaesthesiol Scand     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-01-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370270     Medline TA:  Acta Anaesthesiol Scand     Country:  England    
Other Details:
Languages:  eng     Pagination:  217-23     Citation Subset:  IM    
Copyright Information:
© 2012 The Authors Acta Anaesthesiologica Scandinavica © 2012 The Acta Anaesthesiologica Scandinavica Foundation.
Affiliation:
Department of Anesthesia, Vancouver General Hospital, University of British Columbia, Vancouver, BC, Canada.
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