Comparative evaluation of intrathecal administration of newer local anaesthetic agents Ropivacaine and Levobupivacaine with Bupivacaine in patients undergoing lower limb surgery

Abstract

This study aimed to detect if intrathecal (i.t.) ropivacaine and levobupivacaine provided anaesthesia (satisfactory analgesia and muscular relaxation) and postoperative analgesia of similar quality to bupivacaine in patients undergoing lower limb surgeries. 75 patients were enrolled. Patients were randomly assigned to receive one of the following isobaric intrathecal (i.t.) solutions: bupivacaine 15 mg (n=25), levobupivacaine 15 mg (n=25), or ropivacaine 15 mg (n=25). An i.t. solution was considered effective if an upper sensory level to pinprick of T6 or above was achieved and if intraoperative supplementation was not required. Sensory, motor and hemodynamic changes were recorded. Anaesthesia was effective in 100, 96, and 96% of patients in the bupivacaine 15 mg, levobupivacaine 15 mg, and ropivacaine 15 mg groups, respectively. Bupivacaine and levobupivacaine 15 mg were associated with a significantly superior success rate to that observed in the ropivacaine group (P<0.05). They also provided a longer duration of analgesia and motor block (P<0.05) vs levobupivacaine and ropivacaine). The levobupivacaine and ropivacaine are an interesting alternative to racemic bupivacaine.