A Comparative Evaluation Between Isobaric Bupivacaine And Isobaric 1% 2- Chloroprocaine For Spinal Anaesthesia In Perianal Surgeries - A One Year Hospital Based Randomised Controlled Trial

Abstract

Background and Aims: The number of surgical procedures being performed on anoutpatientbasis under spinal anaesthesia has gradually increased since few years.The choice of local anaesthetic which provides rapid onset and offset of its action has played a crucial role in spinal anaesthesia. Chloroprocaine was used in the 1980s but waswithdrawn due to reported cases of neurotoxicity. This was accounted to the presence of a preservative sodium bisulphite and a low pH. The drug has been reintroduced with a preservative- free formula for the use of ambulatory surgery making it an ideal local anaesthetic for short durationprocedures. This study aims at comparing isobaric 0.5%bupivacaine and isobaric 1%2- chloroprocaine - in terms of onset and duration of sensory and motor blockade and secondarily, in terms of hemodynamic changes and associated complications. Methods:Seventy-eight patientsbelonging to American society of Anaesthesiologists I and II undergoing perianal surgeries under spinal anaesthesia were randomized into two groups. Group A received 3ml of 0.5% isobaric bupivacaine while Group B received 4ml of isobaric 1% 2-chloroprocaine. Student’s unpaired t test and the χ2 test were used to analyze the results, using the SPSS version 18 software. Results: The meanonset of sensory block was significantly faster in Group B (3.59±0.9mins) than in group A (5.41±1.16mins).The mean duration of sensory blockade was shorter in group B (78.00±4.81mins) than in group A (171.31±4.48mins). Themean onset of motor block was faster in group B (4.82±0.79mins) than group A (7.72±0.89mins).The mean duration of motor block was shorter in group B (66.28±4.78mins) than group A (128.54±3.75mins). Isobaricbupivacaine and isobaric bupivacaine had comparable hemodynamic stability. Conclusion:Intrathecal isobaric 1% 2- chloroprocaine is associated with lesser duration of both sensory and motor blockade, thereby enabling quicker recovery from anaesthesia and has comparablehemodynamicstability with isobaric bupivacaine for perianal surgeries.