Document Detail

Spinal 2-chloroprocaine: a comparison with procaine in volunteers.
MedLine Citation:
PMID:  15673896     Owner:  NLM     Status:  MEDLINE    
Recent studies using preservative-free 2-chloroprocaine (2-CP) for spinal anesthesia have shown it to be a reliable short-acting drug that provides similar anesthesia to lidocaine. In this randomized, double-blind, crossover study, we compared the characteristics of spinal 2-CP (30 mg) with those of procaine (80 mg) in eight volunteers to determine whether either drug produces spinal anesthetic characteristics ideal for outpatient surgery. By using sensation to pinprick, transcutaneous electrical stimulation, tolerance to thigh tourniquet, and motor blockade as surrogates for surgical efficacy, 2-CP compared similarly to procaine. Peak block height (T9 [range, T6 to T12] versus T6 [T4 to T8]; P = 0.0796), time to two-segment regression (51 +/- 17 min versus 53 +/- 10 min; P = 0.7434), tourniquet time tolerance (37 +/- 16 versus 49 min +/- 17 min; P = 0.1755), and time to return of motor strength (Bromage scale: 54 +/- 23 min versus 55 +/- 44 min, P = 0.9366; return of 90% quadriceps strength: 78 +/- 9 min versus 98 +/- 30 min; P = 0.0721) were all similar. Procaine did produce overall longer sensory blockade (P = 0.0011) and motor blockade at the gastrocnemius (P = 0.0004) and quadriceps (P = 0.0146) muscles. Times until the resolution of sensory blockade (103 +/- 12 min versus 151 +/- 26 min; P = 0.0003), ambulation (103 +/- 12 min versus 151 +/- 26 min; P = 0.0003), and micturition (103 +/- 12 min versus 156 +/- 23 min; P < 0.0001) were all prolonged after procaine. In conclusion, at the doses tested, spinal 2-CP (30 mg) may be a better choice for short outpatient procedures because it provides anesthesia with similar efficacy as procaine (80 mg) but with more rapid fulfillment of discharge criteria.
Aaron F Gonter; Dan J Kopacz
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Anesthesia and analgesia     Volume:  100     ISSN:  0003-2999     ISO Abbreviation:  Anesth. Analg.     Publication Date:  2005 Feb 
Date Detail:
Created Date:  2005-01-27     Completed Date:  2005-02-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  1310650     Medline TA:  Anesth Analg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  573-9     Citation Subset:  AIM; IM    
Department of Anesthesiology, Virginia Mason Clinic, 1100 Ninth Avenue, Seattle, WA 98111, USA.
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MeSH Terms
Anesthesia, Spinal*
Anesthetics, Local* / administration & dosage
Blood Pressure / drug effects
Cross-Over Studies
Double-Blind Method
Electric Stimulation
Electrocardiography / drug effects
Isometric Contraction / drug effects
Muscle Contraction / drug effects
Muscle, Skeletal / drug effects
Pain Measurement
Procaine* / administration & dosage,  analogs & derivatives*
Prospective Studies
Urinary Bladder / drug effects,  ultrasonography
Reg. No./Substance:
0/Anesthetics, Local; 133-16-4/chloroprocaine; 59-46-1/Procaine
Comment In:
Anesth Analg. 2005 Feb;100(2):549-52   [PMID:  15673892 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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