Intrathecal chloroprocaine or hyperbaric prilocaine for ambulatory knee surgery? A prospective randomized study.

PURPOSE: The aim of this study was to compare intrathecal 1% chloroprocaine with 2% hyperbaric prilocaine in the setting of ambulatory knee arthroscopy. We hypothesized that complete resolution of the sensory block was faster with chloroprocaine. METHODS: Eighty patients scheduled for knee arthroscopy were included in this prospective randomized double-blind study. Spinal anesthesia was performed with either chloroprocaine (50 mg) or hyperbaric prilocaine (50 mg). Characteristics of sensory and motor blocks and side effects were recorded. RESULTS: Mean time to full sensory block recovery was shorter with chloroprocaine (169 (56.1) min vs 248 (59.4)). The characteristics of the sensory blocks were similar at the T12 dermatome level between the two groups. Differences appeared at T10: the percentage of patients with a sensory block was higher, onset quicker and duration longer with hyperbaric prilocaine. The number of patients with a sensory block at T4 dermatome level in both groups was minimal. Times to full motor recovery were identical in both groups (85 (70-99) vs 86 (76-111) min). Time to spontaneous voiding was shorter with chloroprocaine (203 (57.6) min vs 287.3 (47.2) min). Incidence of side effects was low in both groups. CONCLUSIONS: When considering the characteristics of the sensory block, the use of chloroprocaine may allow an earlier discharge of patients. Cephalic extension was to a higher dermatomal level and the sensory block at T10 level was of prolonged duration with hyperbaric prilocaine, suggesting that the choice between the two drugs should also be performed based on the level of the sensory block requested by the surgery. This study is registered in the US National Clinical Trials Registry, registration number: NCT030389 , the first of February 2017, Retrospectively registered.

[Surgical treatment of fractures of the radius neck in children using the Métaizeau technic]. / Traitement chirurgical des fractures du col radial chez l'enfant par la technique de Métaizeau.

Fractures of the radial neck in children must be reduced when the angular displacement is superior to 30 degrees. Given that orthopaedic reduction is difficult, internal fixation using closed intramedullary pinning, as described by Métaizeau in 1980, seems to be an elegant solution which preserves the vascularisation of the physis. The authors report their experience with this technique, which has been used to treat fifteen patients, with a mean age of nine years, between 1983 and 1996. A plaster cast was worn for three weeks after operation and sound union was observed at six weeks. Full functional recovery was observed in all patients at six weeks. No complication was encountered and the pins were removed at three months.