Camponovo Claudio
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Acta Biomed. 2014 Dec 17;85(3):265-8.
2-Chloroprocaine is a local anesthetic with a very short half-life and a favorable evolution of spinal block for ultra-short outpatient procedures. The aim of this retrospective study is to evaluate the clinical impact of the introduction of spinal 1% 2-chloroprocaine compared to general anesthesia at the ARS Medica Clinic (Switzerland).
We retrospectively evaluated the charts of all patients who underwent knee arthroscopy under general anesthesia (group GA) or spinal 2-chloroprocaine (group SA) between June 2012, when chloroprocaine was available for the first time, and December 2012. We collected the anesthesia time and the number of patients able to bypass the PACU. Moreover, we looked at hospital discharge time and we performed a pharmaco-economic analysis.
61 charts were evaluated, 5 patients were excluded for insufficient data. The anesthesia time was comparable between the two groups. All patients in group SA were able to bypass the PACU versus only 18% in group GA. We observed a clinically significant reduction in terms of discharge time (203 vs 326 minutes) and cost of materials and employers involved patients' care (53 vs 78 swiss franks) when spinal 1% 2-chloroprocaine was used.
The right selection of the local anesthetic makes spinal anesthesia a suitable anesthetic technique for ultra-short outpatient procedures. If short acting local anesthetics are involved, spinal anesthesia could be competitive versus general anesthesia.
2-氯普鲁卡因是一种局部麻醉剂，半衰期极短，在超短门诊手术中脊髓阻滞效果良好。本回顾性研究的目的是评估在瑞士ARS Medica诊所引入1%脊髓2-氯普鲁卡因与全身麻醉相比的临床影响。
我们回顾性评估了2012年6月（氯普鲁卡因首次可用）至2012年12月期间在全身麻醉（GA组）或脊髓2-氯普鲁卡因麻醉（SA组）下接受膝关节镜检查的所有患者的病历。我们收集了麻醉时间和能够绕过麻醉后护理单元（PACU）的患者数量。此外，我们观察了出院时间并进行了药物经济学分析。
共评估了61份病历，5例患者因数据不足被排除。两组的麻醉时间相当。SA组所有患者都能够绕过PACU，而GA组只有18%的患者能够做到。当使用1%脊髓2-氯普鲁卡因时，我们观察到出院时间（203分钟对326分钟）以及涉及患者护理的材料和人力成本（53瑞士法郎对78瑞士法郎）在临床上有显著降低。
正确选择局部麻醉剂可使脊髓麻醉成为超短门诊手术的合适麻醉技术。如果使用短效局部麻醉剂，脊髓麻醉与全身麻醉相比可能具有竞争力。
