Intrathecal Chloroprocaine vs. Bupivacaine for Cervical Cerclage

A Randomized Controlled Clinical Trial of Intrathecal Chloroprocaine vs. Bupivacaine for Cervical Cerclage

This study aims to compare the effect of chloroprocaine vs. bupivacaine on duration of motor block and duration until meeting discharge criteria in patients undergoing cervical cerclage. The hypothesis is that chloroprocaine will result in faster resolution of motor block.

Cervical cerclage is an ambulatory surgical procedure of short duration commonly performed under spinal anesthesia. Bupivaciane and chlororpocaine are both commonly used, but how their use impacts clinical care, in particular patient flow, is not well studied.

This is a prospective, randomized, double blind, controlled trial. Participants meeting inclusion criteria will be randomly allocated to receive spinal anesthesia with either chloroprocaine or bupivacaine.

Patients will then be assessed for motor block and sensory level until they are discharged from the recovery room.

Inclusion Criteria:

• ASA classification II or III females
• Age: 18-45 years old
• BMI ≤ 50 kg/m2
• Singleton pregnancy
• Simple prophylactic cervical cerclage
• Planning neuraxial anesthesia

Exclusion Criteria:

• Abdominal and complex cervical cerclage (e.g. bulging bag)
• Contraindication to neuraxial anesthesia
• Known hypersensitivity to chloroprocaine (a.k.a. Ester allergy), paraaminobenzoic acid (PABA) or bupivacaine (a.k.a. Amide allergy)
• Pseudocholinesterase deficiency
• Concomitant use with ergot-type oxytocic drugs