Comparing Spinal Anesthesia With 1% Chloroprocaine Versus 1% Mepivacaine in Patients Undergoing Outpatient Primary Total Knee Arthroplasty

NCT ID: NCT07239999

Last Updated: 2026-02-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

170 participants

Study Classification

INTERVENTIONAL

Study Start Date

2026-03-31

Study Completion Date

2027-06-15

Brief Summary

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This study or clinical trial looking to compare 2 types of freezing medications injected into the spinal fluid at the lower back between the vertebrae in patients going to have total knee replacement surgery to check for early legs movement, early discharge from recovery room, walking and hospital discharge. This could save hospital cost of such procedures.

Detailed Description

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Conditions

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Recovery Period Anesthesia

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

SINGLE

Caregivers
Surgeons, PACU Nurses, OR Nurses, Physical therapists

Study Groups

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One arm receives spinal Mepivacaine 50 mg

One arm receives spinal Mepivacaine 50mg for total knee arthroplasty with adductor canal block

Group Type ACTIVE_COMPARATOR

Mepivacaine Injection

Intervention Type DRUG

Comparing time to motor block recovery in PACU, time to PACU discharge, time to ambulation and length of hospital stay

Spinal Chloroprocaine group

Group Type ACTIVE_COMPARATOR

Chloroprocaine Injection

Intervention Type DRUG

Comparing time to motor block recovery in PACU, time to PACU discharge, time to ambulation and length of hospital stay

Interventions

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Mepivacaine Injection

Comparing time to motor block recovery in PACU, time to PACU discharge, time to ambulation and length of hospital stay

Intervention Type DRUG

Chloroprocaine Injection

Comparing time to motor block recovery in PACU, time to PACU discharge, time to ambulation and length of hospital stay

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* ASA I-III
* Elective outpatient TKA
* BMI less than 40
* Ability to provide surgical consent

Exclusion Criteria

* Patient refusal
* Opioid tolerant
* Any contraindications to spinal anesthesia
* Chronic opioid use 3months or more
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Nova Scotia Health Authority

OTHER

Sponsor Role lead

Responsible Party

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Husam Nashnoush

Doctor Husam Nashnoush, MBBCH, FRCPC, Anesthesia Department, Central Zone, DGH, Halifax , NS

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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HUSAM M NASHNOUSH, MBBCH, FRCPC

Role: PRINCIPAL_INVESTIGATOR

Dalhousie University

Central Contacts

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HUSAM M NASHNOUSH, MBBCH, FRCPC

Role: CONTACT

001-902-410-9062

Mohamed H Nashnoush, MED2

Role: CONTACT

001-902-266-6010

References

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Herndon CL, Martinez R, Sarpong NO, Geller JA, Shah RP, Cooper HJ. Spinal Anesthesia Using Chloroprocaine is Safe, Effective, and Facilitates Earlier Discharge in Selected Fast-track Total Hip Arthroplasty. Arthroplast Today. 2020 Jun 1;6(3):305-308. doi: 10.1016/j.artd.2020.04.007. eCollection 2020 Sep.

Reference Type BACKGROUND
PMID: 32509943 (View on PubMed)

Callaghan JJ, Mont MA. Editorial: Proceedings of the Knee Society: A Knee Society-Journal of Arthroplasty Collaborative Partnership! J Arthroplasty. 2022 Jun;37(6S):S1. doi: 10.1016/j.arth.2022.02.078. Epub 2022 Feb 26. No abstract available.

Reference Type BACKGROUND
PMID: 35227811 (View on PubMed)

Teunkens A, Vermeulen K, Van Gerven E, Fieuws S, Van de Velde M, Rex S. Comparison of 2-Chloroprocaine, Bupivacaine, and Lidocaine for Spinal Anesthesia in Patients Undergoing Knee Arthroscopy in an Outpatient Setting: A Double-Blind Randomized Controlled Trial. Reg Anesth Pain Med. 2016 Sep-Oct;41(5):576-83. doi: 10.1097/AAP.0000000000000420.

Reference Type BACKGROUND
PMID: 27281722 (View on PubMed)

Lacasse MA, Roy JD, Forget J, Vandenbroucke F, Seal RF, Beaulieu D, McCormack M, Massicotte L. Comparison of bupivacaine and 2-chloroprocaine for spinal anesthesia for outpatient surgery: a double-blind randomized trial. Can J Anaesth. 2011 Apr;58(4):384-91. doi: 10.1007/s12630-010-9450-x. Epub 2011 Jan 4.

Reference Type BACKGROUND
PMID: 21203878 (View on PubMed)

Gilreath N, Liu J, Thomson C, Daher M, Caus S, Dunn H, Antoci V Jr, Barrett T, Cohen E. Retrospective comparison of chloroprocaine and mepivacaine in spinal anesthesia for same-day discharge TKA. Knee Surg Relat Res. 2025 Aug 7;37(1):33. doi: 10.1186/s43019-025-00283-4.

Reference Type BACKGROUND
PMID: 40775385 (View on PubMed)

Alhefeiti K, Patrascu AM, Lustig S, Aubrun F, Dziadzko M. Perioperative Outcomes in Patients Who Received Spinal Chloroprocaine for Total Hip or Knee Arthroplasty-Consecutive Case Series Study. J Clin Med. 2022 Sep 29;11(19):5771. doi: 10.3390/jcm11195771.

Reference Type BACKGROUND
PMID: 36233638 (View on PubMed)

Ghisi D, Boschetto G, Spinelli AM, Giannone S, Frugiuele J, Ciccarello M, Bonarelli S. Spinal anaesthesia with Chloroprocaine HCl 1% for elective lower limb procedures of short duration: a prospective, randomised, observer-blind study in adult patients. BMC Anesthesiol. 2021 Feb 20;21(1):58. doi: 10.1186/s12871-021-01279-9.

Reference Type BACKGROUND
PMID: 33610175 (View on PubMed)

Pillow CF, Brewbaker C, Wolf BJ, Barrett W, Hansen E, Brown A, Crawford D, Wilson SH. Mepivacaine versus bupivacaine spinal anesthesia for return of motor function following total knee arthroplasty: a randomized controlled trial. Reg Anesth Pain Med. 2025 May 1:rapm-2024-106342. doi: 10.1136/rapm-2024-106342. Online ahead of print.

Reference Type BACKGROUND
PMID: 40316299 (View on PubMed)

Schwenk ES, Kasper VP, Smoker JD, Mendelson AM, Austin MS, Brown SA, Hozack WJ, Cohen AJ, Li JJ, Wahal CS, Baratta JL, Torjman MC, Nemeth AC, Czerwinski EE. Mepivacaine versus Bupivacaine Spinal Anesthesia for Early Postoperative Ambulation. Anesthesiology. 2020 Oct 1;133(4):801-811. doi: 10.1097/ALN.0000000000003480.

Reference Type BACKGROUND
PMID: 32852904 (View on PubMed)

Forster JG. Short-acting spinal anesthesia in the ambulatory setting. Curr Opin Anaesthesiol. 2014 Dec;27(6):597-604. doi: 10.1097/ACO.0000000000000126.

Reference Type BACKGROUND
PMID: 25211156 (View on PubMed)

Siddiqi A, Mahmoud Y, Secic M, Tozzi JM, Emara A, Piuzzi NS, Culp B, Schwarzkopf R, Springer BD, Chen AF. Mepivacaine Versus Bupivacaine Spinal Anesthesia for Primary Total Joint Arthroplasty: A Systematic Review and Meta-Analysis. J Arthroplasty. 2022 Jul;37(7):1396-1404.e5. doi: 10.1016/j.arth.2022.03.031. Epub 2022 Mar 17.

Reference Type BACKGROUND
PMID: 35306162 (View on PubMed)

Wyles CC, Pagnano MW, Trousdale RT, Sierra RJ, Taunton MJ, Perry KI, Larson DR, Amundson AW, Smith HM, Duncan CM, Abdel MP. More Predictable Return of Motor Function with Mepivacaine Versus Bupivacaine Spinal Anesthetic in Total Hip and Total Knee Arthroplasty: A Double-Blinded, Randomized Clinical Trial. J Bone Joint Surg Am. 2020 Sep 16;102(18):1609-1615. doi: 10.2106/JBJS.20.00231.

Reference Type BACKGROUND
PMID: 32960532 (View on PubMed)

Mahan MC, Jildeh TR, Tenbrunsel TN, Davis JJ. Mepivacaine Spinal Anesthesia Facilitates Rapid Recovery in Total Knee Arthroplasty Compared to Bupivacaine. J Arthroplasty. 2018 Jun;33(6):1699-1704. doi: 10.1016/j.arth.2018.01.009. Epub 2018 Jan 16.

Reference Type BACKGROUND
PMID: 29429882 (View on PubMed)

Camponovo C, Wulf H, Ghisi D, Fanelli A, Riva T, Cristina D, Vassiliou T, Leschka K, Fanelli G. Intrathecal 1% 2-chloroprocaine vs. 0.5% bupivacaine in ambulatory surgery: a prospective, observer-blinded, randomised, controlled trial. Acta Anaesthesiol Scand. 2014 May;58(5):560-6. doi: 10.1111/aas.12291. Epub 2014 Mar 6.

Reference Type BACKGROUND
PMID: 24601887 (View on PubMed)

Casati A, Fanelli G, Danelli G, Berti M, Ghisi D, Brivio M, Putzu M, Barbagallo A. Spinal anesthesia with lidocaine or preservative-free 2-chlorprocaine for outpatient knee arthroscopy: a prospective, randomized, double-blind comparison. Anesth Analg. 2007 Apr;104(4):959-64. doi: 10.1213/01.ane.0000258766.73612.d8.

Reference Type BACKGROUND
PMID: 17377114 (View on PubMed)

Goldblum E, Atchabahian A. The use of 2-chloroprocaine for spinal anaesthesia. Acta Anaesthesiol Scand. 2013 May;57(5):545-52. doi: 10.1111/aas.12071. Epub 2013 Jan 16.

Reference Type BACKGROUND
PMID: 23320599 (View on PubMed)

Capdevila X, Aveline C, Delaunay L, Bouaziz H, Zetlaoui P, Choquet O, Jouffroy L, Herman-Demars H, Bonnet F. Impact of Chloroprocaine on the Eligibility for Hospital Discharge in Patients Requiring Ambulatory Surgery Under Spinal Anesthesia: An Observational Multicenter Prospective Study. Adv Ther. 2020 Jan;37(1):541-551. doi: 10.1007/s12325-019-01172-5. Epub 2019 Dec 11.

Reference Type BACKGROUND
PMID: 31828611 (View on PubMed)

Wesselink E, Hurk GJD, Vegt RV, Slagt C, Aa JV, Franssen E, Ven PV, Swart N, Boer C, Leeuw M. Chloroprocaine versus prilocaine for spinal anesthesia in ambulatory knee arthroscopy: a double-blind randomized trial. Reg Anesth Pain Med. 2019 Aug 21:rapm-2019-100673. doi: 10.1136/rapm-2019-100673. Online ahead of print.

Reference Type BACKGROUND
PMID: 31439640 (View on PubMed)

Kim SW, Khandaker R, Muse IO, Pulverenti T, Goman M, Patel J, Yedlin A, Balikai CP, Levine R, Choice C, Montilla Medrano E. 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. Reg Anesth Pain Med. 2024 Dec 31:rapm-2024-106130. doi: 10.1136/rapm-2024-106130. Online ahead of print.

Reference Type BACKGROUND
PMID: 39740957 (View on PubMed)

Singh NP, Siddiqui NT, Makkar JK, Guffey R, Singh PM. Optimal local anesthetic for spinal anesthesia in patients undergoing ambulatory non-arthroplasty surgery: a systematic review and Bayesian network meta-analysis of randomized controlled trials. Can J Anaesth. 2025 Apr;72(4):550-566. doi: 10.1007/s12630-025-02924-4. Epub 2025 Apr 8.

Reference Type BACKGROUND
PMID: 40199797 (View on PubMed)

Forget P, Borovac JA, Thackeray EM, Pace NL. Transient neurological symptoms (TNS) following spinal anaesthesia with lidocaine versus other local anaesthetics in adult surgical patients: a network meta-analysis. Cochrane Database Syst Rev. 2019 Dec 1;12(12):CD003006. doi: 10.1002/14651858.CD003006.pub4.

Reference Type BACKGROUND
PMID: 31786810 (View on PubMed)

Khurana BJK, Choudhary S, Singhal M, Rautela RS, Salhotra R, Singh A, Meena S. Comparison of Intrathecal Chloroprocaine With Bupivacaine in Short Gynecological Procedures: A Randomized Double-Blind Study. Cureus. 2023 Aug 27;15(8):e44187. doi: 10.7759/cureus.44187. eCollection 2023 Aug.

Reference Type BACKGROUND
PMID: 37767250 (View on PubMed)

Gu L, Smith CR, Ihnatsenka B, Zasimovich Y, Le-Wendling L. Comparing Spinal Chloroprocaine to Hyperbaric and Isobaric Bupivacaine for Total Hip and Knee Arthroplasties: A Retrospective Study. Cureus. 2023 Mar 3;15(3):e35729. doi: 10.7759/cureus.35729. eCollection 2023 Mar.

Reference Type BACKGROUND
PMID: 37016653 (View on PubMed)

Other Identifiers

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DGH2025

Identifier Type: -

Identifier Source: org_study_id

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