title: A multicenter study of the analgesic effects of epidural chloroprocaine after lower limb orthopedic surgery.
abstract: OBJECTIVE
  To investigate the effects and optimal concentration of chloroprocaine for epidural analgesia after lower limb orthopedic surgery.
  
  
  METHODS
  Prospective, randomized, observational, multicenter clinical study.
  
  
  METHODS
  Operating room, postoperative recovery area, university hospital.
  
  
  METHODS
  One hundred and twenty patients from 4 hospitals were enrolled and randomized into 5 groups after lower limb orthopedic surgery under epidural anesthesia with lidocaine.
  
  
  METHODS
  Epidural chloroprocaine mixed with 0.4μg/mL fentanyl was administered via a patient-controlled analgesia pump at the concentration of 0.6%, 0.8%, 1.0%, 1.2%, or 1.4% after the surgery.
  
  
  METHODS
  Systolic blood pressure, heart rate, visual analog score at rest and during activity, as well as the Bromage score at 0 minute, 30 minutes, 1 hour, 2 hours, 4 hours, 8 hours, 24 hours, and 48 hours after the surgery were recorded and compared. Use of morphine and incidence of adverse effects were also recorded.
  
  
  RESULTS
  Patients given 1.2% chloroprocaine showed the lowest visual analog score compared with other groups. There was no significant difference in the Bromage score among 5 groups. The Bromage score returned to 0 in 89.7% of the patients 48 hours after surgery. No difference in postoperative morphine usage, blood pressure, or heart rate was found among 5 groups.
  
  
  CONCLUSIONS
  Epidural 1.2% chloroprocaine with 0.4μg/mL fentanyl could generate proper analgesic effects with little influence on mobility in patients undergoing lower limb orthopedic surgery. In addition, it could generate a good sense and movement separation, facilitating the early functional training.
authors.affiliation: Department of Anesthesiology, Laboratory of Anesthesia and Critical Care Medicine, Translational Neuroscience Center, West-China Hospital of Sichuan University, Guoxuexiang 37, Chengdu, Sichuan, 610041, China.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Anesthesiology, Laboratory of Anesthesia and Critical Care Medicine, Translational Neuroscience Center, West-China Hospital of Sichuan University, Guoxuexiang 37, Chengdu, Sichuan, 610041, China.
authors.forename: Huiping
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, Laboratory of Anesthesia and Critical Care Medicine, Translational Neuroscience Center, West-China Hospital of Sichuan University, Guoxuexiang 37, Chengdu, Sichuan, 610041, China.
authors.forename: Yunxia
authors.initials: Y
authors.lastname: Zuo
authors.affiliation: Department of Anesthesiology, Peking University People's Hospital, No. 11 Xizhimen South St, Xicheng District, Beijing, 100044, China.
authors.forename: Baxian
authors.initials: B
authors.lastname: Yang
authors.affiliation: Department of Anesthesiology, Huazhong University of Science and Technology Affiliated Tongji Hospital, 1095 Jie Fang Ave, Wuhan 430030, China.
authors.forename: Yuke
authors.initials: Y
authors.lastname: Tian
authors.affiliation: Department of Anesthesiology, Xiangya Hospital of Central-South University, 87 Xiangya Rd, Changsha, Hunan, 410008, China.
authors.forename: Qulian
authors.initials: Q
authors.lastname: Guo
authors.affiliation: Department of Anesthesiology, Nanjing General Hospital of Nanjing Military Command, 305 East Zhongshan Rd, Xuanwu District, Nanjing, Jiangsu, 210002, China.
authors.forename: Jianguo
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Anesthesiology, Laboratory of Anesthesia and Critical Care Medicine, Translational Neuroscience Center, West-China Hospital of Sichuan University, Guoxuexiang 37, Chengdu, Sichuan, 610041, China. Electronic address: chaoranwu@aliyun.com.
authors.forename: Chaoran
authors.initials: C
authors.lastname: Wu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult; D015360:Analgesia, Epidural / Q000009:adverse effects; D016058:Analgesia, Patient-Controlled / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000767:Anesthesia, Epidural; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D005283:Fentanyl / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008012:Lidocaine / Q000008:administration & dosage; D035002:Lower Extremity; D009020:Morphine / Q000008:administration & dosage; D009043:Motor Activity / Q000187:drug effects; D019637:Orthopedic Procedures / Q000009:adverse effects; D059408:Pain Management / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy; D011343:Procaine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000494:pharmacology / Q000627:therapeutic use; D011446:Prospective Studies
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; C004616:chloroprocaine; D004338:Drug Combinations; D005283:Fentanyl; D008012:Lidocaine; D009020:Morphine; D011343:Procaine
keywords: Bromage score; Chloroprocaine; Epidural analgesia; Lower limb; Orthopedic surgery; Visual analog score