title: Intrathecal chloroprocaine vs. lidocaine in day-case surgery: recovery, discharge and effect of pre-hydration on micturition.
abstract: BACKGROUND
  This randomised, double blind prospective study compares intrathecal lidocaine with chloroprocaine in day-case surgery and the influence of a 500 ml pre-load intravenously. We tested the hypothesis that chloroprocaine provides faster recovery and discharge in day-case surgery. Secondary we studied the influence of a preload compared with fluid restriction on discharge time and micturition problems.
  
  
  METHODS
  One hundred patients undergoing day-case arthroscopy were randomised to receive either lidocaine (L) 60 mg or chloroprocaine (CP) 40 mg intrathecally and this with (L+, CP+) or without (L−, CP−) a 500 ml pre-load of crystalloid. Block characteristics, micturition and discharge times were registered. Bladder volumes were monitored by ultrasound. Micturition problems received a micturition score.
  
  
  RESULTS
  Onset and quality of the block were comparable between groups. Time to regain Bromage 1 and L2 regression were shorter for the CP group compared with the L group. Voiding (168 ± 44 min) and discharge (178 ± 52 min) were approximately 40 min faster for the CP group compared with the L group. Pre-load provided faster bladder filling but there were no differences in voiding time within the CP or L group. The CP+ group (166 ± 36 min) was discharged faster than both L groups (226 ± 57 min, 227 ± 59 min). More serious micturition problems occurred in the L+ group compared with both CP groups.
  
  
  CONCLUSIONS
  Chloroprocaine is suitable for day-case surgery because of faster block regression and discharge than lidocaine. A 500 ml pre-load may not affect discharge but did not increase micturition problems for chloroprocaine.
authors.forename: M B
authors.initials: MB
authors.lastname: Breebaart
authors.forename: A
authors.initials: A
authors.lastname: Teune
authors.forename: L A
authors.initials: LA
authors.lastname: Sermeus
authors.forename: M P
authors.initials: MP
authors.lastname: Vercauteren
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000762:Anesthesia Recovery Period; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local; D001182:Arthroscopy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D008012:Lidocaine; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy; D011183:Postoperative Complications / Q000453:epidemiology; D011343:Procaine / Q000031:analogs & derivatives*; D011446:Prospective Studies; D001743:Urinary Bladder / Q000033:anatomy & histology; D014554:Urination / Q000187:drug effects*; D014555:Urination Disorders / Q000453:epidemiology
chemical_list: D000779:Anesthetics, Local; D011343:Procaine; C004616:chloroprocaine; D008012:Lidocaine