Reduced urinary retention using spinal anesthesia with chloroprocaine versus bupivacaine in total joint arthroplasty: A matched retrospective cohort study

Reduced POUR: Chloroprocaine in TJA Chloroprocaine is emerging as a short-acting alternative to bupivacaine for spinal anesthesia in joint arthroplasty. In this retrospective matched cohort study, 50 patients undergoing primary total hip or knee arthroplasty with chloroprocaine were matched to 50 patients receiving bupivacaine. Outcomes included postoperative day 0 ambulation, postoperative urinary retention, and 90-day readmission. Chi-square tests and multivariable logistic regression were used for analysis. Urinary retention was significantly lower with chloroprocaine compared to bupivacaine (4% vs. 22%; p = 0.007). No significant differences were observed in postoperative day 0 ambulation or 90-day readmission rates. Secondary analysis identified younger age as a predictor of early ambulation, while procedure type was associated with reduced urinary retention. Spinal anesthesia with chloroprocaine was associated with a significantly lower incidence of postoperative urinary retention compared with bupivacaine and may be advantageous for patients at risk of this complication.