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Spinal 2-Chloroprocaine: Minimum Effective Dose
  1. Dan J. Kopacz, M.D.
  1. From the Department of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington.
  1. Reprint requests: Dan J. Kopacz, M.D., Department of Anesthesiology, Virginia Mason Clinic, 1100 Ninth Avenue, B2-AN, Seattle, WA 98111. E-mail: Dan.Kopacz{at}vmmc.org

Abstract

Background and Objectives: Recent studies using preservative-free 2-chloroprocaine (2-CP) for spinal anesthesia have shown it to be a reliable short-acting agent in the 30-mg to 60-mg range. Investigations of doses below this range have not been performed.

Methods: To establish the minimum effective dose for spinal anesthesia, this randomized, double-blind, crossover study investigates the characteristics of spinal 2-CP 10 mg and 20 mg in 8 volunteers and compares the results with previous data obtained for 30 to 60 mg in the same human model.

Results: Peak block height, regression to L1, tolerance to tourniquet, and transcutaneous electrical stimulation all increased with increasing doses from 10 to 60 mg (P < .0001). Likewise, time to complete block regression, ambulation, and micturition also increased with increasing spinal 2-CP dosage (P < .0001). Degree of motor block generally increased with increasing doses from 10 to 60 mg; however, no differences existed between the 20-mg and 30-mg and between the 40-mg and 60-mg doses.

Conclusions: Spinal 2-CP 40 mg and 60 mg provide rapid and reliable sensory and motor block. Although the 20-mg and 30-mg doses can produce sensory anesthesia adequate for brief surgical procedures, less motor block and some sacral sparing should be anticipated. Because the 10-mg dose produces only brief and inconsistent sensory anesthesia, it can be considered a no-effect dose.

  • Anesthetic techniques
  • 2-Chloroprocaine
  • Local anesthetics
  • Outpatient anesthesia
  • Spinal anesthesia

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Footnotes

  • Reprints will not be available.

    Portions of this work have been submitted for presentation to the American Society of Anesthesiologists Annual Meeting, Las Vegas, Nevada, October, 2004.