Prospective Comparative Study Between Subarachnoid Chloroprocaine and General Anesthesia for Short Daycare Surgeries.

Introduction: Daycare surgeries are increasingly possible due to advancements in anesthetic techniques, the availability of newer drugs, and newer surgical techniques. The anesthetic technique has to be modified and titrated to a level so as to provide optimal anesthesia with minimal side effects that will enable the patients to resume their daily activities. General anesthesia and newer airway adjuncts have completely changed non-invasive airway management in daycare surgeries. Chloroprocaine (CP) is an amino-ester local anesthetic with a very short half-life and is the recommended local anesthetic agent for spinal anesthesia in patients undergoing ambulatory surgeries because of its low incidences of adverse side effects, superior recovery profile, and raised operating room efficiency.

Method: A prospective, comparative, randomized, double-blinded study was performed on 60 patients. These patients were divided into two groups: Group C (CP) with 30 patients and Group G (general anesthesia) with 30 patients. The groups were compared for early postoperative recovery and discharge.

Result: The mean time of the first analgesic (min) was lower in Group G (15.2±3.0) than in Group C (26.3±3.04), and the difference was statistically significant. In our study, the maximum number of patients in Group C had a score of 12 compared to Group G, with a highly significant difference of 0.001, denoting that patients in Group C had more stable hemodynamic and ventilatory parameters and were ready to be discharged earlier than Group G patients. The mean time of discharge from PACU (min) was higher in Group G (49.5±6.4) than in Group C (22.7±4.5), and the difference was statistically significant.

Conclusion:  Spinal anesthesia with CP is significantly superior to general anesthesia because patients who receive it have a longer initial rescue analgesic requirement duration, stable ventilatory and hemodynamic parameters, and an early mean time of PACU discharge.