Purpose: To document the clinical characteristics of procaine with or without the addition of epinephrine. Methods: In this randomized, prospective, double blind study, 62 patients received spinal anesthesia with 100 mg procaine and either 0.3 mg epinephrine (EPI group) or 0.3 ml NaG 0.9% (SALINE group). Sensory anesthesia to needle prick was evaluated q I rain for I 0 min, q 3 rain for 33 rain and q 5 rain until regression to L 4. Motor block was assessed with the Bromage scale. Patients were questioned, by telephone, for transient radicular irritation (-I-RI) 48 hr later. Results: Time to reach highest sensory level and number of segments blocked showed no difference. Mean time for regression of the sensory level to T t 0 was longer in EPI (83 --+ 23 vs 66 -+- 20 rain, P < 0.01). Time to recuperate to full flexion of knees and feet (Bromage 4) was longer in EPI (I 26 - 37 vs 100 _-_ 30 rain, P < 0.0 I). Patients in EPI received more ephedrine. Eighteen patients had nausea (15 EPI 13 SALINE, P < 0.0015). One patient had TRI, incidence: 1.67%, 95% Cl (< I%-9%). Cond~ion: Spinal procaine is appropriate for surgery of short duration. Epinephrine prolongs sensory and motor blocks by 25%. However, it is associated with a high incidence of nausea.
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