EFFICACY OF INTRATHECAL CHLOROPROCAINE AND BUPIVACAINE ON CLINICAL OUTCOMES IN PATIENTS UNDERGOING DAY-CASE SURGERY: A DESCRIPTIVE STUDY
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Date
2025-11-30
Authors
Haj Hamad, Raheeq
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Publisher
An-Najah National University
Abstract
Background: Day-case procedures require anaesthetics with rapid onset, effective anesthesia, prompt recovery, and minimal complications. Bupivacaine provides extended analgesia but causes delayed recovery and potential hemodynamic instability. Chloroprocaine offers a swift onset and recovery; however, its use in outpatient surgery in Palestine remains inadequately investigated.
Aim: To evaluate the efficacy and safety of intrathecal chloroprocaine compared with bupivacaine in patients undergoing outpatient (day-case) surgery by assessing key clinical outcomes.
Methods: A descriptive comparative cross sectional study was conducted at Al Itihad Hospital in Nablus, Palestine, from March to June 2025. One hundred adult patients (ages 18-65) undergoing elective outpatient procedures under spinal anesthesia were randomized to receive either intrathecal chloroprocaine (Group A) or intrathecal bupivacaine (Group B). Primary outcomes measured were block properties and motor/sensory regression times. Secondary outcomes included hemodynamic stability, postoperative analgesia requirements, ambulation time, and complications. Data were analyzed using SPSS version 21, with p < 0.05 considered significant.
Results: Chloroprocaine demonstrated faster sensory (3.12 ± 0.56 min) and motor block onset (4.92 ± 0.63 min) compared to bupivacaine (4.26 ± 0.53 min and 5.68 ± 0.86 min, respectively; p < 0.01). The chloroprocaine group experienced shorter block duration. This has lead to quicker ambulation and discharge. More chloroprocaine patients required postoperative analgesics (66% vs. 38%; p = 0.003). Hemodynamic measures including hypotension, bradycardia, and hypertension showed no significant differences between groups. No serious complications occurred.
Conclusion: Both chloroprocaine and bupivacaine are safe and effective for spinal anesthesia in outpatient procedures. Chloroprocaine offers rapid onset, reduced recovery time, and expedited discharge but requires more postoperative analgesia.