Regional Anesthesia in Lumbar Endoscopic Spine Surgery: Intrathecal Bupivacaine Versus Chloroprocaine

Objective: To analyze and compare postoperative recovery metrics and outcomes in patients undergoing short-duration uniportal endoscopic lumbar discectomy under spinal anesthesia utilizing bupivacaine versus chloroprocaine.Methods: This retrospective study analyzed 24 single-level uniportal endoscopic discectomy cases. Patients received spinal anesthesia in the lateral decubitus position with either bupivacaine (n=12) or chloroprocaine (n=12), with all procedures performed by the same surgeon. Primary postoperative outcomes included motor block duration, time to mobilization and ambulation, postoperative visual analogue scale (VAS) scores, requirement for urinary catheterization, and time to discharge from the Post Anesthesia Care Unit (PACU).Results: A statistically significant difference (p<0.05) was observed in postoperative recovery metrics between the 2 groups. The chloroprocaine group demonstrated expedited postoperative milestones, including earlier ambulation, reduced PACU length of stay, and a more rapid initiation of postoperative rehabilitation compared to the bupivacaine group.Conclusion: Spinal anesthesia with chloroprocaine facilitates accelerated postoperative recovery, positioning it as a favorable alternative for short-duration uniportal endoscopic lumbar discectomy. However, its judicious utilization should be restricted to surgical procedures anticipated to last less than 1 hour given its pharmacokinetic profile.