Abstract
BackgroundThis study was undertaken to compare and evaluate the efficacy of 3-ml 0.5% isobaric levobupivacaine versus 3-ml 0.75% isobaric ropivacaine in patients undergoing elective lower abdominal and lower limb surgeries.MethodsWe allocated 60 patients into two groups (n=30 each) to receive either a spinal block of 3-ml 0.5% isobaric levobupivacaine (group L) or 3-ml 0.75% isobaric ropivacaine (group R). Haemodynamic parameters were measured intraoperatively till the end of surgery and postoperatively for two hours. The onset and duration of sensory block and motor block were recorded. Adverse events were also recorded. The student’s unpaired t-test was used for comparing the continuous variables.ResultsThe mean age in group L was 37.83 ±16.51 years and the mean age in group R was 38.50 ±12.97 years. The mean onset of sensory block in group L (6.97 ±1.82 mins) was significantly faster than in group R (8.47 ±2.55 mins), p<0.05. Similarly, so was the mean onset of motor block in group L (10.27 ±1.92 mins) versus group R (12.93 ±2.55 mins), p<0.05. The mean duration of sensory block in group L (147.63 ±27.53 mins) was significantly longer than in group R (97.40 ±12.38 mins), p<0.05, as was the mean duration of motor block in group L (207.33 ±22.27 mins) versus group R (146.60 ±21.22 mins), p<0.05. In group L, 13.3% of patients had complications, with hypotension being the most common (6.7%); in group R, 40% had complications, of which bradycardia was the most common (13.3%).ConclusionThere was an earlier onset of sensory and motor block and prolonged duration of sensory and motor block with intrathecal administration of 3-ml 0.5% isobaric levobupivacaine as compared to 3-ml 0.75% isobaric ropivacaine. Haemodynamic parameters were more stable with levobupivacaine than ropivacaine. Adverse effects were more common with ropivacaine.
Highlights
Lower abdominal and lower limb surgeries may be performed under regional or general anaesthesia
Bupivacaine 0.5% heavy was the only drug used for spinal anaesthesia after the discontinuation of intrathecal use of lidocaine
Patients who were American Society of Anesthesiologists (ASA) status III and IV, pregnant and lactating patients, those with a history of bleeding disorders, those who were allergic to local anaesthetics, patients on anticoagulants, those suffering from infection at the site of spinal needle insertion, those having spinal abnormalities like spina bifida, meningocele or those who refused to give consent were excluded
Summary
Lower abdominal and lower limb surgeries may be performed under regional (spinal, epidural, or both) or general anaesthesia. Levobupivacaine is an S (-) enantiomer of the long-acting local anaesthetic bupivacaine, having less cardiotoxic and central nervous system effects in comparison with bupivacaine [3]. Levobupivacaine and ropivacaine were introduced a few years ago, to our knowledge, there are very few studies on the use of isobaric levobupivacaine 0.5% and isobaric ropivacaine 0.75% for spinal anaesthesia for obstetric, abdominal and orthopaedic surgeries, and levobupivacaine has been found to be. This study was undertaken to compare and evaluate the efficacy of 3-ml 0.5% isobaric levobupivacaine versus 3-ml 0.75% isobaric ropivacaine in patients undergoing elective lower abdominal and lower limb surgeries
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