Background and Aims While permitting complete surgical anesthesia, subarachnoid blocks for ambulatory surgery are underused because of risk for urinary retention and delayed recovery of motor functions . 1% Chloroprocaine is a fast onset and offset drug, which allows rapid recovery .
We report our experience with different short-duration surgical procedures.
Methods With the patients‘ consent, 60 short procedures were carried out under spinal anesthesia with 1% chloroprocaine, with a 27 pencil-point needle; different injection levels and dosages were used achieving different results.
Data regarded: type of procedures and duration; heart rate, blood pressure; pain; block level and Bromage score trends; complications.
Results Procedures: urologic n. 15; hysteroscopy n. 8; foot n. 11; hernia n. 12; knee arthroscopy and stem cell treatment n.7; pilonidal cyst n. 2; liposuction n.5.
Durations ranged between 15 and 80 minutes. Higher dosages (40–50 mg) lead to a decrease in blood pressure and heart rate when the injection level was L1-L2 or higher. IV Atropine avoids or restores physiologic heart rate. With lithotomy position, hypotension occurred less frequently. No patient experienced pain, with one exception of a hysteroscopy which received 30 mg at L2-L3 interspace. No complications were recorded. Levels and Bromage trends are displayed in table 1.
Conclusions Spinal anesthesia with 1% chloroprocaine is a valid technique for short surgeries. From our experience, we may assume that 35–40 mg administered between T12 and L2 provide a reliable block up to T9-T10 lasting 40 minutes and regressing within 90 minutes, without significant hemodynamic changes. Research trials are needed to confirm our data.