Key result
Intrathecal 2-chloroprocaine speeds complete sensory regression by ~140 minutes and hastens motor recovery vs ropivacaine.
Why the study?
Local anesthetics with rapid onset, good analgesia, short recovery, and minimal side effects are preferred for spinal anesthesia in inguinal hernia surgeries.
Does intrathecal 1% isobaric 2-chloroprocaine provide faster block resolution and earlier discharge compared to 0.5% isobaric ropivacaine in patients undergoing elective inguinal hernia surgeries?
RCT (n=60)
Single-blind
slips-in the box technique
No
Does intrathecal 1% isobaric 2-chloroprocaine provide faster block resolution and earlier discharge compared to 0.5% isobaric ropivacaine in patients undergoing elective inguinal hernia surgeries?
Intrathecal 2-chloroprocaine provides faster block resolution and earlier hospital discharge compared to ropivacaine for inguinal hernia surgeries.
Supports further evaluation of intrathecal 1% isobaric 2-chloroprocaine for day-care hernia repair; leaves open routine adoption pending larger trials.
Background: Inguinal hernia repair is one of the most common surgical conditions. In the absence of other comorbidities, it can be performed as a day-care procedure. Spinal anesthesia is most preferred technique this surgery. Local anesthetics having rapid and smooth onset of action, good intraoperative analgesia, short recovery period, and least side effects are preferred. Aims and Objectives: The objective of the study was to compare the anesthetic efficacy of intrathecal 1% isobaric 2-chloroprocaine (CP) and 0.5% isobaric ropivacaine for inguinal hernia surgeries. Materials and Methods: Sixty patients with ASA grade I/II scheduled for elective inguinal hernia surgeries were randomly allocated into group C (n=30), received 3 mL of 1% isobaric 2- CP and group R (n=30), received 3 mL of 0.5% isobaric ropivacaine intrathecally. Results: Demographic profile, mean time for onset of sensory blockade at T10, highest level of sensory blockade, and maximum motor blockade were comparable among the groups (P>0.05). The highest level of sensory blockade in group C is T7 and group R is T8. The mean time to two segment regression, complete sensory regression, complete motor recovery, recovery of parameters for achieving discharge criteria such as time to unassisted ambulation, drink water, micturition, and first rescue analgesia were significantly shorter in group C (P<0.0001). Visual analog scale score at the time of first rescue analgesia was significantly higher in group C (P<0.0001). Intraoperative hemodynamic changes and perioperative side effects were comparable (P>0.05). Conclusion: CP provides faster block resolution, earlier hospital discharge, and early ambulation with minimal side effects, making it a better alternative to ropivacaine for inguinal hernia surgeries.
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Tirkey et al. (2023) conducted an RCT in Inguinal hernia (n=60). 1% isobaric 2-chloroprocaine vs. 3 mL of 0.5% isobaric ropivacaine was evaluated on Time to complete sensory regression (minutes) (p=<0.001). Intrathecal 1% isobaric 2-chloroprocaine provided significantly faster complete sensory regression (75.03 vs 215.06 minutes) and motor recovery compared to 0.5% isobaric ropivacaine.
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