A COMPARATIVE STUDY BETWEEN 0.5% BUPIVACAINE (HEAVY) AND 2- CHLOROPROCAINE (PRESERVATIVE FREE) FOR SPINAL ANAESTHESIA IN ELECTIVE SHORT SURGICAL PROCEDURES

Abstract

Background: Spinal anaesthesia is the preferred anaesthetic technique in lower abdominal surgeries but in case of short surgeries (< 60 min), appropriate choice of local anaesthetic is of prime importance to prevent problems like prolonged motor block, delayed ambulation and delayed micturition postoperatively. Preservative free 2-Chloroprocaine has recently come up as a good alternative as compared to commonly used local anaesthetics. Aim: The aim of this study was to compare the efcacy between 1% 2-Chloroprocaine and 0.5% Bupivacaine (heavy) in terms of early block resolution and early ambulation. Material And Methods: This prospective, randomised, double blinded, comparative study was conducted in the Department of Anaesthesiology, North Bengal Medical College and Hospital. One hundred and ten (110) patients of ASA physical status I or II and age of 18-60 yrs undergoing lower abdominal surgeries under spinal anaesthesia were chosen and randomly divided into two groups, Group A and Group B. Group A received 40 mg (4ml) of intrathecal 1% preservative free 2-Chloroprocaine and Group B received 12 mg (2.4ml) of intrathecal 0.5% Bupivacaine (heavy). After administration of intrathecal drugs, vital parameters were monitored and any intraoperative complications recorded. Onset and height of sensory block were monitored by pinprick method and degree of motor block was monitored by modied Bromage Scale – (0-3). Time to reach readiness for surgery, duration of sensory block and motor block, time to ambulation and micturition, any supplementation required and any complications were recorded. The data were analysed using appropriate statistical tests. Results: The patients in Group A had a lower duration of motor block in comparision to those in Group B [81 ± 11 min vs 142 ± 29 min (P<0.001)]. The duration of sensory block was also signicantly lower in Group A as compared to Group B [100 ± 14 min vs 188 ± 39 min (P<0.001)]. Also patients in Group A had lower time to ambulation than those in Group B[142 ± 24 min vs 280 ± 51 min (P<0.001)] as well as lower time to micturition as compared to those in Group B[204 ± 37 min vs 365 ± 57 min (P<0.001)]. Conclusion: For spinal anaesthesia in lower abdominal short surgical procedures, intrathecal 2-Chloroprocaine produces a satisfactory surgical block and is a better drug in comparison to hyperbaric bupivacaine with respect to faster block resolution and ambulation.