{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T08:00:08Z","timestamp":1777536008966,"version":"3.51.4"},"reference-count":27,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2024,12,11]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Preservative-free chloroprocaine is a promising spinal anesthetic for ambulatory surgeries, offering a short duration of action and minimal side effects, which promote faster recovery and discharge. Thus, this study aimed to compare chloroprocaine hydrochloride to the widely used bupivacaine as a spinal anesthetic in ambulatory anorectal surgeries. We hypothesized that chloroprocaine will lead to quicker recovery and discharge, supporting its use in the ambulatory surgical setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this double-blind randomized controlled trial, 110\u2009patients were randomized to 1% chloroprocaine or 0.75% bupivacaine treatment groups. Due to the inability to place a spinal anesthetic, five\u2009patients were excluded (one in chloroprocaine and four in bupivacaine groups). The co-primary endpoints were recovery time (defined as the time of motor and sensory function return), and time discharge criteria were met. The secondary endpoint was the onset of transient neurological symptoms (TNS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The chloroprocaine group had a significantly shorter time to meet discharge criteria (191.4\u00b16.6\u2009min) than the bupivacaine group (230.9\u00b19.4\u2009min; p=&lt;0.001). There were no significant differences between interventions for recovery time. No TNS were recorded within 24 hours after the procedure for both groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study demonstrated a significantly reduced time to meeting discharge criteria with chloroprocaine compared with bupivacaine without an increased risk of TNS. Our results support the use of chloroprocaine for spinal anesthesia in ambulatory anorectal surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03324984\">NCT03324984<\/jats:ext-link>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rapm-2024-106130","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T11:10:18Z","timestamp":1735643418000},"page":"324-329","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of 1% chloroprocaine hydrochloride versus hyperbaric bupivacaine spinal in patients undergoing anorectal surgery in an ambulatory surgery center: a double-blind randomized clinical trial"],"prefix":"10.1136","volume":"51","clinical-trial-number":[{"clinical-trial-number":"nct03324984","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"nct03324984","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1960-3958","authenticated-orcid":false,"given":"Seung W","family":"Kim","sequence":"first","affiliation":[{"name":"Albert Einstein College of Medicine, Bronx, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7874-7379","authenticated-orcid":false,"given":"Rafi","family":"Khandaker","sequence":"additional","affiliation":[{"name":"Anesthesiology, Montefiore Medical Center, Bronx, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iyabo O","family":"Muse","sequence":"additional","affiliation":[{"name":"Anesthesiology, University of Virginia Health System, Charlottesville, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy","family":"Pulverenti","sequence":"additional","affiliation":[{"name":"Anesthesiology, Montefiore Medical Center, Bronx, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4394-6744","authenticated-orcid":false,"given":"Mikhail","family":"Goman","sequence":"additional","affiliation":[{"name":"Anesthesiology, Hospital for Special Surgery, New York, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jashvin","family":"Patel","sequence":"additional","affiliation":[{"name":"Anesthesiology, Cayuga Medical Center, Ithaca, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adam","family":"Yedlin","sequence":"additional","affiliation":[{"name":"Anesthesiology, Montefiore Medical Center, Bronx, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chandrappa P","family":"Balikai","sequence":"additional","affiliation":[{"name":"Anesthesiology, Montefiore Medical Center, Bronx, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Levine","sequence":"additional","affiliation":[{"name":"Surgery, Montefiore Medical Center, Bronx, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Curtis","family":"Choice","sequence":"additional","affiliation":[{"name":"Anesthesiology, Montefiore Medical Center, Bronx, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elilary","family":"Montilla Medrano","sequence":"additional","affiliation":[{"name":"Anesthesiology, Montefiore Medical Center, Bronx, New York, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2024,12,31]]},"reference":[{"key":"2026031205150954000_51.3.324.1","unstructured":"Steiner CA , Karaca Z , Moore BJ , et al . Surgeries in Hospital-Based Ambulatory Surgery and Hospital Inpatient Settings. 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Transient neurologic symptoms (TNS) following spinal anaesthesia with lidocaine versus other local anaesthetics. Cochrane Database Syst Rev 2009:CD003006. doi:10.1002\/14651858.CD003006.pub3","DOI":"10.1002\/14651858.CD003006.pub3"},{"key":"2026031205150954000_51.3.324.10","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199611000-00026"},{"key":"2026031205150954000_51.3.324.11","article-title":"Transient neurological symptoms (TNS) following spinal anaesthesia with lidocaine versus other local anaesthetics in adult surgical patients: a network meta-analysis","volume":"12","author":"Forget","year":"2019","journal-title":"Cochrane Database Syst Rev"},{"key":"2026031205150954000_51.3.324.12","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aeg078"},{"key":"2026031205150954000_51.3.324.13","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199610000-00009"},{"key":"2026031205150954000_51.3.324.14","doi-asserted-by":"publisher","DOI":"10.1007\/BF03028311"},{"key":"2026031205150954000_51.3.324.15","unstructured":"Tonder S , Togioka BM , Maani CV . Chloroprocaine. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright \u00a9 2024. StatPearls Publishing LLC; 2024."},{"key":"2026031205150954000_51.3.324.16","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1097\/ACO.0000000000000126","article-title":"Short-acting spinal anesthesia in the ambulatory setting","volume":"27","author":"F\u00f6rster","year":"2014","journal-title":"Curr Opin Anaesthesiol"},{"key":"2026031205150954000_51.3.324.17","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000420"},{"key":"2026031205150954000_51.3.324.18","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1111\/aas.12291","article-title":"Intrathecal 1% 2-chloroprocaine vs. 0.5% bupivacaine in ambulatory surgery: a prospective, observer-blinded, randomised, controlled trial","volume":"58","author":"Camponovo","year":"2014","journal-title":"Acta Anaesthesiol Scand"},{"key":"2026031205150954000_51.3.324.19","doi-asserted-by":"crossref","first-page":"12","DOI":"10.4103\/aer.aer_20_22","article-title":"Randomized Controlled Study Comparing 2-Chloroprocaine and Bupivacaine for Spinal Anesthesia in Gynecological Surgeries","volume":"16","author":"Thomas","year":"2022","journal-title":"Anesth Essays Res"},{"key":"2026031205150954000_51.3.324.20","doi-asserted-by":"crossref","first-page":"266","DOI":"10.4103\/aer.AER_43_20","article-title":"A Prospective Open-Label Randomized Controlled Trial to Compare Intrathecal 1% 2-Chloroprocaine Versus 0.5% Bupivacaine in Ambulatory Elective Surgeries","volume":"14","author":"Singh","year":"2020","journal-title":"Anesth Essays Res"},{"key":"2026031205150954000_51.3.324.21","article-title":"A Comparative Study of Isobaric 1% Chloroprocaine With 0.5% Isobaric Bupivacaine for Ureteroscopic Lithotripsy Under Spinal Anaesthesia: A Prospective Randomised Study","volume":"14","author":"M","year":"2022","journal-title":"Cureus"},{"key":"2026031205150954000_51.3.324.22","doi-asserted-by":"publisher","DOI":"10.1136\/rapm-2020-101603"},{"key":"2026031205150954000_51.3.324.23","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199907000-00016"},{"key":"2026031205150954000_51.3.324.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2018.06.010"},{"key":"2026031205150954000_51.3.324.25","doi-asserted-by":"publisher","DOI":"10.1016\/S1521-6896(02)00113-1"},{"key":"2026031205150954000_51.3.324.26","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.amjsurg.2007.12.064","article-title":"Factors associated with delayed postsurgical voiding interval in ambulatory spinal anesthesia patients: a prospective cohort study in 3 types of surgery","volume":"197","author":"Linares Gil","year":"2009","journal-title":"Am J Surg"},{"key":"2026031205150954000_51.3.324.27","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.jclinane.2018.09.003","article-title":"Does spinal chloroprocaine pharmacokinetic profile actually translate into a clinical advantage in terms of clinical outcomes when compared to low-dose spinal bupivacaine? 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