Yang Zhengchao, Li Dezhan, Zhang Kun, Yang Fang, Li Man, Wang Lishen
1 Department of Anesthesiology, Wuhan No. 1 Hospital, Wuhan, Hubei, China.
2 Department of Anesthesiology, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jingzhou, Hubei, China.
J Orthop Surg (Hong Kong). 2019 Sep-Dec;27(3):2309499019865534. doi: 10.1177/2309499019865534.
This study aimed to compare clinical efficacy and safety of chloroprocaine and lidocaine in epidural anesthesia for outpatient knee arthroscopy. Eighty patients undergoing knee arthroscopy were randomly allocated to receive 3% 2-chloroprocaine (group C, = 40) or 2% lidocaine (group L, = 40) for epidural block. Latency to anesthesia onset, highest block level, time to achieve peak effect, time to complete sensory and motor block regression, vital signs including respiration and hemodynamics, and complications during follow-up were recorded. No significant differences were found in the latency to anesthesia onset and peak effect, duration of anesthesia efficacy, and the time for recovery of sensory function between the two groups. However, the latency to maximal block of pain sensation and the time needed to recover motor function were significantly shorter in group C than in group L ( < 0.05). No adverse effects or neurologic complications were found in both groups. In conclusion, epidural chloroprocaine elicits rapid anesthetic effects, fast sensor and motor block, and faster recovery of motor function compared to lidocaine. These characteristics make chloroprocaine better than lidocaine as the choice of epidural anesthesia in short clinical operations such as knee arthroscopy.
本研究旨在比较氯普鲁卡因和利多卡因用于门诊膝关节镜检查硬膜外麻醉时的临床疗效及安全性。80例行膝关节镜检查的患者被随机分为两组,分别接受3% 2 - 氯普鲁卡因(C组,n = 40)或2%利多卡因(L组,n = 40)进行硬膜外阻滞。记录麻醉起效潜伏期、最高阻滞平面、达到峰值效应的时间、感觉和运动阻滞消退时间、包括呼吸和血流动力学在内的生命体征以及随访期间的并发症。两组在麻醉起效潜伏期、峰值效应时间、麻醉效果持续时间以及感觉功能恢复时间方面均未发现显著差异。然而,C组疼痛感觉最大阻滞的潜伏期和运动功能恢复所需时间明显短于L组(P < 0.05)。两组均未发现不良反应或神经并发症。综上所述,与利多卡因相比,硬膜外注射氯普鲁卡因起效迅速,感觉和运动阻滞快,运动功能恢复更快。这些特性使氯普鲁卡因在诸如膝关节镜检查等短时间临床手术中作为硬膜外麻醉的选择优于利多卡因。