COMPARISON OF INTRA OPERATIVE EFFECTS AND POST OPERATIVE OUTCOME BETWEEN INTRATHECAL CHLOROPROCAINE AND CHLOROPROCAINE WITH FENTANYL FOR URETEROSCOPIC LITHOTRIPSY.

Abstract

With the advent of Ambulatory surgery, the search for an ideal anaesthetic for outpatient spinal anaesthesia is ongoing.⁽¹⁾ An ideal anaesthetic is one that provides rapid onset of action, adequate potency, predictable duration with decreased side effects.⁽²⁾ Among the various local anaesthetics available, Chloroprocaine – an amino ester – has been the forerunner in satisfying these criteria. It was first introduced in the year 1952 by Foldes and McNall and was found to be superior in efficacy and safety as compared to Procaine and Lidocaine.⁽³⁾ However, due to reports of neurological deficits following intrathecal administration of chloroprocaine, in the early 1980s, its use drastically decreased and low dose Bupivacaine was preferred.⁽⁴⁾ Extensive investigation revealed that a combination of low pH and sodium bisulfite, an antioxidant, could be the cause of neurotoxicity. Hence, an anti-oxidant and preservative free 2-choloroprocaine was developed  and is now one of the preferred drugs for short duration spinal anaesthesia.⁽⁵⁾