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Hospital Discharge After Ambulatory Knee Arthroscopy: A Comparison of Epidural 2-Chloroprocaine Versus Lidocaine
  1. Joseph M. Neal, M.D.,
  2. Joseph J. Deck, M.D.,
  3. Dan J. Kopacz, M.D. and
  4. Marjorie A. Lewis, M.D.
  1. From the Department of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington.
  1. Correspondence: Joseph M. Neal, M.D., Department of Anesthesiology (B2-AN), Virginia Mason Medical Center, 1100 Ninth Ave, Seattle, WA 98111. E-mail: anejmn{at}vmmc.org

Abstract

Background and Objectives This prospective, randomized, double-blind study compares the efficacy of epidural 2-chloroprocaine and lidocaine for attaining hospital discharge criteria after ambulatory knee arthroscopy. We hypothesized that 2-chloroprocaine would facilitate earlier discharge than lidocaine.

Methods American Society of Anesthesiologists (ASA) I and II patients were randomized to receive equipotent doses of epidural 3% 2-chloroprocaine or 1.5% lidocaine, both without epinephrine. Time to block resolution and discharge were compared between groups, along with the need for epidural reinjection, surgical times, and postoperative back pain.

Results Twenty-seven patients completed the study, 13 in the 2-chloroprocaine group and 14 in the lidocaine group. The 2-chloroprocaine group was ready for discharge significantly earlier than the lidocaine group (130 ± 17 min [range, 105 to 160] v 191 ± 32 min [range 144 to 251]; P < .0001, 90% power). The lidocaine group required more epidural reinjections. Anesthesia-related side effects were similar in both groups.

Conclusions Epidural 3% 2-chloroprocaine without epinephrine is an advantageous choice for ambulatory knee arthroscopy. It enables readiness for discharge an hour sooner than 1.5% lidocaine, requires fewer reinjection interventions, and may reduce delayed discharge secondary to prolonged time to void. This clinical study shows the superiority of epidural 3% 2-chloroprocaine over 1.5% lidocaine for expediting hospital discharge after ambulatory surgery.

  • 2-Chloroprocaine
  • Ambulatory anesthesia
  • Discharge time
  • Epidural

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Footnotes

  • Presented in part at the Annual Meeting of the American Society of Regional Anesthesia, May 13-16, 1993, Seattle, WA.