Camponovo C, Wulf H, Ghisi D, Fanelli A, Riva T, Cristina D, Vassiliou T, Leschka K, Fanelli G
Department of Anaesthesiology, Regional Hospital, Lugano, Switzerland.
Acta Anaesthesiol Scand. 2014 May;58(5):560-6. doi: 10.1111/aas.12291. Epub 2014 Mar 6.
This prospective, observer-blinded, randomised, multicentre study aimed at determining the non-inferiority of 50 mg of plain 1% 2-chloroprocaine vs. 10 mg of 0.5% plain bupivacaine in terms of sensory block onset time at T10 after spinal injection. The study hypothesis was that the difference in onset times of sensory block to T10 between the two drugs is ≤ 4 min.
One hundred and thirty patients undergoing lower abdominal or lower limb procedures (≤ 40 min) were randomised to receive one of two treatments: 50 mg of plain 1% 2-chloroprocaine (Group C, n = 66) or 10 mg of plain 0.5% bupivacaine (Group B, n = 64). Times to sensory and motor block onsets, maximum sensory block level, readiness for surgery, regression of sensory and motor blocks, first analgesic requirements, unassisted ambulation, home discharge, and side effects after 24 h and 7 days were registered blindly.
Chloroprocaine was comparable with plain 0.5% bupivacaine in terms of time to sensory block at T10 level. Group C showed faster onsets of motor block (5 vs. 6 min), maximum sensory block level (8.5 vs. 14 min), resolution of sensory (105 vs. 225 min) and motor (100 vs. 210 min) blocks, unassisted ambulation (142.5 vs. 290.5 min), first analgesic requirement (120 vs. 293.5 min), and home discharge (150 vs. 325 min) (all comparisons, P < 0.05). No chloroprocaine patient developed transient neurological symptoms.
Spinal anaesthesia with 50 mg of plain 1% 2-chloroprocaine is similar to 10 mg of plain 0.5% bupivacaine in terms of onset of sensory block at T10 but shows quicker recovery from anaesthesia than with 0.5% bupivacaine.
这项前瞻性、观察者盲法、随机、多中心研究旨在确定50毫克普通1% 2 - 氯普鲁卡因与10毫克0.5%普通布比卡因在脊髓注射后T10水平感觉阻滞起效时间方面的非劣效性。研究假设是两种药物至T10感觉阻滞起效时间的差异≤4分钟。
130例接受下腹部或下肢手术（≤40分钟）的患者被随机分配接受两种治疗之一：50毫克普通1% 2 - 氯普鲁卡因（C组，n = 66）或10毫克普通0.5%布比卡因（B组，n = 64）。盲目记录感觉和运动阻滞起效时间、最大感觉阻滞平面、手术准备情况、感觉和运动阻滞消退情况、首次镇痛需求、自主行走情况、出院回家情况以及24小时和7天后的副作用。
在T10水平感觉阻滞时间方面，氯普鲁卡因与普通0.5%布比卡因相当。C组运动阻滞起效更快（5分钟对6分钟）、最大感觉阻滞平面出现更快（8.5分钟对14分钟）、感觉（105分钟对225分钟）和运动（100分钟对210分钟）阻滞消退更快、自主行走更快（142.5分钟对290.5分钟）、首次镇痛需求出现更晚（120分钟对293.5分钟）以及出院回家更早（150分钟对325分钟）（所有比较，P < 0.05）。没有氯普鲁卡因患者出现短暂性神经症状。
50毫克普通1% 2 - 氯普鲁卡因脊髓麻醉在T10感觉阻滞起效方面与10毫克普通0.5%布比卡因相似，但比0.5%布比卡因麻醉恢复更快。
