Comparative Study of Isobaric Levobupivacaine Alone and Isobaric Levobupivacaine with Fentanyl for Spinal Anaesthesia in Lower Abdominal Surgeries

Abstract

Introduction: Levobupivacaine 0.5% and racemic bupivacaine 0.5% are equally effective in spinal anaesthesia with less systemic toxicity seen with levobupivacaine. Fentanyl has been used as an adjunct to racemic bupivacaine in spinal anaesthesia. This study was designed to study on the intrathecal use of 0.5% levobupivacaine with fentanyl in elective lower abdominal surgeries. Methods: A prospective randomized controlled double blind study was conducted in100 patients of ASA I and II physical status posted for elective lower abdominal surgeries under subarachnoid block, randomized into 2 groups with 50 patients each, received either 3 ml of 0.5% isobaric levobupivacaine (group L) or 2.8 mL of 0.5% levobupivacaine with fentanyl 10 µg in 0.2 mL (group F). Hemodynamic parameters, time for onset of sensory and motor blockade, maximum height of sensory block and total duration of sensory and motor blockade were recorded. Intraoperative or postoperative side effects werenoted. Results: There were no significant differences between the two groups in the haemodynamic changes, and quality of sensory and motor block. Anaesthesia was adequate and patient satisfaction was good in all cases. Sideeffects were minor and infrequent with both regimes. Conclusions: We conclude that,in terms of efficacy, 2.8 mL of 0.5% levobupivacaine with fentanyl 10µg is comparable to 3 mL of 0.5% levobupivacaine alone in spinal anaesthesia for lower abdominal surgeries. Further studies may be directed to find the optimal combination of levobupivacaine and opioid for spinal anaesthesia. Keywords: Levobupivacaine; Analgesics; Opioid; Fentanyl; Anesthetic techniques; Anaesthesia; Spinal.