Using chloroprocaine for spinal anaesthesia in outpatient knee-arthroscopy results in earlier discharge and improved operating room efficiency compared to mepivacaine and prilocaine
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Knee arthroscopies are regularly carried out in an outpatient setting. The purpose of this retrospective analysis was to investigate the impact of different local anaesthetics for spinal anaesthesia on operating room efficiency (perioperative process times) and postoperative recovery. This study aims to determine the optimal LA for SPA in patients undergoing knee arthroscopy at a day-surgery centre.
Anaesthesia records of all patients undergoing knee arthroscopy under spinal anaesthesia from 2010 until 2017 were analysed. Patients were categorised as having received spinal anaesthesia with prilocaine, mepivacaine or chloroprocaine.
Three-hundred and nine patients were included. Postoperative recovery was significantly faster for chloroprocaine 1% compared with both other local anaesthetics regarding all stages of recovery until discharge. Perioperative processes and surgery time were significantly shorter when chloroprocaine was used. Early postoperative pain occurred more frequently and earlier after spinal anaesthesia with chloroprocaine. Nevertheless, pain intensity did not differ between groups.
Spinal anaesthesia provides reliable blocks for outpatient knee arthroscopy. Considerations on the choice of local anaesthetic for spinal anaesthesia must include not only the recovery profile, but also the impact on operating room efficiency. Due to a superior recovery profile, low incidences of adverse side effects and raised operating room efficiency, chloroprocaine is the recommendable local anaesthetic for spinal anaesthesia in patients undergoing knee arthroscopy in an ambulatory setting. Since the frequency of SPA in patients undergoing outpatient knee arthroscopy is rising yearly, the results of this study are of high clinical relevance. The use of chloroprocaine leads to improved recovery, optimized perioperative processes and consecutively to a raised OR efficiency.
Level of evidence
KeywordsAmbulatory surgery Spinal anaesthesia Knee arthroscopy Operating room efficiency
No external funding was used.
Compliance with ethical standards
Conflict of interest
M. D. Schmittner and V. Gebhardt received speaker fees and travel funding from Sintetica, Switzerland and Germany. S. Hausen and C. Weiss have no conflict of interest.
This article does not contain any studies with human participants performed by any of the authors.
- 8.Fuzier R, Bataille B, Fuzier V, Richez AS, Magues JP, Choquet O et al (2011) Spinal anesthesia failure after local anesthetic injection into cerebrospinal fluid: a multicenter prospective analysis of its incidence and related risk factors in 1214 patients. Reg Anesth Pain Med 36:322–326CrossRefGoogle Scholar
- 9.Gebhardt V, Monnard M, Weiss C, Schmittner M (2014) Discharge times for knee arthroscopy in spinal vs. general anesthesia. Cent Eur J Med 9:446–454Google Scholar
- 12.Hemping-Bovenkerk A, Moellmann M (2014) Anaesthesia in ambulatory surgery. Anaesth Intensiv Med 55:228–244Google Scholar
- 16.Manassero A, Bossolasco M, Ugues S, Bailo C, Liarou C, Coletta G (2014) Comparison of unilateral and bilateral spinal anesthesia with 2% hyperbaric prilocaine in day-case inguinal herniorrhaphy: a randomized controlled trial. Miner Anestesiol 80:685–691Google Scholar
- 21.Teunkens A, Vermeulen K, Van Gerven E, Fieuws S, Van de Velde M, Rex S (2016) Comparison of 2-chloroprocaine, bupivacaine, and lidocaine for spinal anesthesia in patients undergoing knee arthroscopy in an outpatient setting: a double-blind randomized controlled trial. Reg Anesth Pain Med 41:576–583CrossRefGoogle Scholar
- 23.Zaric D, Pace NL (2009) Transient neurologic symptoms (TNS) following spinal anaesthesia with lidocaine versus other local anaesthetics. Cochrane Database Syst Rev 4:CD003006Google Scholar