Spinal Anesthesia Using Chloroprocaine is Safe, Effective, and Facilitates Earlier Discharge in Selected Fast-track Total Hip Arthroplasty

Arthroplasty Today
Carl L HerndonH John Cooper

Abstract

Spinal anesthetic choice plays an underappreciated role in total hip arthroplasty (THA). Chloroprocaine, a short-acting local anesthetic, has been limited to short-duration ambulatory procedures and has not been studied in THA. We compare perioperative outcomes of patients undergoing fast-track THA using chloroprocaine spinal anesthesia with those who have surgery with a longer-acting agent (bupivacaine). A total of 143 THAs performed under spinal anesthesia by 3 arthroplasty surgeons between November 2018 and July 2019 were retrospectively reviewed. Patients receiving chloroprocaine were matched 1:1 by demographics to patients receiving bupivacaine. Ultimately, 74 patients were included (37 chloroprocaine and 37 bupivacaine). The primary outcome was hospital length of stay (LOS). Other perioperative outcomes were also evaluated. A total of 37 patients (50%) received chloroprocaine (60 mg), whereas 37 (50%) received bupivacaine (median 10 mg, range 8-15 mg). Among the matched groups, chloroprocaine use was associated with shorter hospital LOS (0.9 vs 1.2 days; P = .03), shorter operative time (68.2 vs 83.6 minutes, P = .03), lower estimated blood loss (184.7 vs 218.9 mL, P = .02), shorter postanesthesia care unit LOS (139.4 vs ...Continue Reading

Citations

Oct 2, 2020·Current Opinion in Anaesthesiology·Mark A Skues
Oct 2, 2020·Current Opinion in Anaesthesiology·Jesse StewartGirish P Joshi
Jan 20, 2021·The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons·Molly VoraPaul Tornetta

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total hip arthroplasty

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