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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 Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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

III.

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Funding

No external funding was used.

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Authors and Affiliations

  1. Department of Anaesthesiology and Surgical Intensive Care Medicine, University Medical Centre Mannheim, Ruprecht-Karls-University Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Volker Gebhardt & Sebastian Hausen

  2. Department of Anaesthesiology, Intensive Care and Pain Medicine, BG Klinikum Unfallkrankenhaus Berlin gGmbH, Warener Str. 7, 12683, Berlin, Germany

    Marc D. Schmittner

  3. Department of Medical Statistics, University Medical Centre Mannheim, Ruprecht-Karls-University Heidelberg, Heinrich-Lanz-Zentrum, 68135, Mannheim, Germany

    Christel Weiss

  4. Medical Faculty Mannheim of Heidelberg University, Ruprecht-Karls-University Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany

    Marc D. Schmittner

Authors
  1. Volker Gebhardt
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  2. Sebastian Hausen
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  3. Christel Weiss
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  4. Marc D. Schmittner
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Corresponding author

Correspondence to Volker Gebhardt.

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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.

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This article does not contain any studies with human participants performed by any of the authors.

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Gebhardt, V., Hausen, S., Weiss, C. et al. Using chloroprocaine for spinal anaesthesia in outpatient knee-arthroscopy results in earlier discharge and improved operating room efficiency compared to mepivacaine and prilocaine. Knee Surg Sports Traumatol Arthrosc 27, 3032–3040 (2019). https://doi.org/10.1007/s00167-018-5327-2

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  • DOI: https://doi.org/10.1007/s00167-018-5327-2

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