Outpatient Surgery Magazine

COVID-19 Crisis - April 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://magazine.outpatientsurgery.net/i/1234902

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Page 61 of 114

Fast-acting, powerful and short in duration — spinal blocks are ide- ally suited for lower-body same-day surgeries, especially as more com- plex procedures such as total knee replacements migrate to outpa- tient centers. Old drug, new option The use of chloroprocaine as a spinal anesthetic began to develop in the 2000s, and the FDA approved it for use as a spinal anesthetic in 2017. It had fallen out of favor because of adjutant preservatives that caused some neurologic problems, according to Michael Aziz, MD, a professor of anesthesiology and perioperative medicine at Oregon Health & Science University in Portland. He says those preservatives are no longer present in modern preparations. "Preservative-free chloroprocaine anesthetics are well-suited for ambulatory surgery," he notes. The drug is fast-acting, usually taking full effect in three to five minutes after injection, but it also breaks down quickly — making it a great tool for the rapid in-and-out pace of outpatient surgery. Dr. Aziz says the blocks reliably last 60 to 90 minutes, and reliably return motor and bladder function as well. Unless sedatives are used in tandem, the patient is fully conscious during the operation, and less likely to suffer the kinds of hangover effects experienced by patients who undergo general anesthesia. "I'd say the over the last couple of years, as we've started to see joint arthroplasties performed in ambulatory centers, chloroprocaine is being used as a spinal anesthetic," he says. "It also supports knee procedures — arthroscopy, ACL reconstruction and meniscal sur- gery." Cholorprocaine is also terrific for short procedures such as inguinal hernias and knee scopes, after which you don't want the patient to 6 2 • O U T PA T I E N T S U R G E R Y M A G A Z I N E • A P R I L 2 0 2 0

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