Intrathecal Isobaric 1% 2-Chloroprocaine versus Hyperbaric 0.5% Bupivacaine in Parturients Undergoing Lower Segment Cesarean Section

Abstract

Background: Cesarean sections are usually done under spinal anesthesia (SA) using local anesthetics. This study is aimed to compare the efficacy of intrathecal isobaric 1% 2-chloroprocaine (CP) and hyperbaric 0.5% bupivacaine in parturients undergoing lower segment cesarean section (LSCS). Materials and Methods: One hundred parturients aged 18–35 years with the American Society of Anesthesiologists physical status I or II undergoing LSCS were randomly allocated into two groups. Group A (n = 50) received intrathecal isobaric 1% 2-CP 5 ml (50 mg), while Group B (n = 50) received intrathecal hyperbaric 0.5% bupivacaine 2 ml (10 mg) in SA. Onset and duration of both sensory and motor block, highest dermatomal level achieved, time to achieve highest dermatomal level, two-segment regression, duration of analgesia, hemodynamic changes, and side effects were noted. Results: The onset of sensory blockade was significantly faster in Group A (1.66 ± 0.49 min) compared to Group B (3.00 ± 0.58 min) (P < 0.05). Duration of sensory block was significantly shorter in Group A (P < 0.05). The time of two-segment regression was also significantly faster in Group A (41.44 ± 5.41 min) compared to Group B (70.24 ± 10.38 min) (P < 0.05). The onset time of the motor block was significantly faster in Group A (P < 0.05). Duration of motor blockade was significantly shorter in Group A (95.7 ± 9.8 min) as compared to Group B (186.26 ± 13.5 min) (P < 0.05). Duration of analgesia was significantly shorter in Group A (97.22 ± 11.82 min) when compared to Group B (191.58 ± 37.06 min) (P < 0.05). No significant hemodynamic changes and side effects were noted (P > 0.05). Conclusion: Intrathecal 1% 2-CP (50 mg) appears to be a safe and effective alternative, preferably in elective and uncomplicated LSCS, as it has faster onset and predictable sensory block height with shorter but adequate duration of motor block and analgesia.