0.5% Versus 1.0% 2-Chloroprocaine for Intravenous Regional Anesthesia: A Prospective, Randomized, Double-Blind Trial
| Autor: | Domenic Scharplatz, Stephan Marsch, Mathias Sluga, Jonas Barandun, Wolfgang Studer, Wolfgang Ummenhofer |
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| Rok vydání: | 2004 |
| Předmět: |
Adult
Male medicine.medical_specialty Randomization medicine.drug_class medicine.medical_treatment Double-Blind Method Forearm Anesthesia Conduction Confidence Intervals medicine Humans Prospective Studies Anesthetics Local Infusions Intravenous Prospective cohort study Intravenous regional anesthesia Aged Tourniquet Local anesthetic business.industry Middle Aged Surgery Anesthesiology and Pain Medicine medicine.anatomical_structure Anesthesia Cuff Female business Procaine Chloroprocaine medicine.drug |
| Zdroj: | Anesthesia & Analgesia. :1789-1793 |
| ISSN: | 0003-2999 |
| Popis: | In this randomized prospective double-blind study we tested the hypothesis that compared with 40 mL chloroprocaine 0.5%, 40 mL chloroprocaine 1% results in an earlier onset to analgesia duration and improves distal tourniquet tolerance in 150 patients undergoing forearm surgery under IV regional anesthesia using a double-cuff technique, switching from the proximal to the distal cuff was performed if pain scores increased above 4 of 10. Switching to the distal cuff resulted in pain scores below 4 in 69% of patients in the 0.5% group and in 88% of patients in the 1% group (P = 0.047). In addition, both groups differed in the sustained effect on distal tourniquet pain (P = 0.020). Time between injection and onset to analgesia duration was 13 +/- 1 min in the 0.5% group and 11 +/- 1 min in the 1% group (P = 0.0006). On release of the tourniquet, signs of systemic local anesthetic toxicity occurred in 6 patients of the 0.5% group and 28 of the 1% group (P0.0001). We conclude that chloroprocaine 1% resulted in an earlier onset of analgesia and improved distal tourniquet tolerance. However, these beneficial effects must be weighed against a fourfold increase in side effects.Compared to a standard dose of 40 mL 0.5% chloroprocaine, 40 mL 1% chloroprocaine resulted in an earlier onset of analgesia duration and improved distal tourniquet tolerance during IV regional anesthesia. These beneficial effects must be weighed against a fourfold increase in signs of systemic local anesthetic toxicity. |
| Databáze: | OpenAIRE |
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