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A Randomized Controlled Trial of Intrathecal Chloroprocaine vs. Bupivacaine for Cervical Cerclage
Abstract Number: T2D-272
Abstract Type: Original Research
Cervical cerclage is an ambulatory surgical procedure commonly performed under neuraxial anesthesia. Bupivacaine, commonly used for spinal anesthesia, is considered a “longer acting” local anesthetic, whose block may last significantly longer than necessary for cervical cerclage. Alternatively, chloropropaine is a shorter acting agent with faster recovery time (1, 2). The aim of this study was to determine if there is a difference in duration of motor block. Our hypothesis was that chloroprocaine would result in shorter duration of motor block.
After IRB approval and written informed consent, parturients undergoing a prophylactic McDonald cervical cerclage from 10/2/2017 to 8/24/2018 at an academic institution were randomized to receive an equal volume of either chloroprociane 40 mg or bupivacaine 7.5 mg for spinal anesthesia. A blinded observer recorded the evolution of sensory and motor block until complete regression, as well as time to ambulation and micturition. The primary outcome was duration of motor block. Student’s t-test and Kaplan-Meier’s method were used to statistical analysis.
Of 18 parturients approached, 10 parturients were recruited and randomized. The duration of motor block was for chloroprocaine vs. bupivacaine was 75±6 vs. 99±48 min, p=0.36. Comparing chloroprocaine vs. bupivacaine, there were differences in the duration of sensory block (127±20 vs. 210±56 min, p=0.02, see figure) and the duration until micturition (111±31 vs. 233±40 min, p=0.002).
While duration of motor block was similar between the two groups, parturients receiving chloroprocaine had shorter duration of sensory block and time to micturition. The lack of difference in motor block may be due to the doses used or small sample size.