Levobupivacaine versus ropivacaine in patients undergoing lower abdominal surgeries

Abstract

Regional anesthesia, like Peripheral nerve block, is commonly used for peripheral surgeries to reduce severe intraoperative and postoperative pain relief. .Some studies with levobupivacaine have shown that duration of analgesia of levobupivacaine are longer compared to that of an equivalent dose of bupivacaine or ropivacaine.This study is done to compare efficacy and safety of levobupivacaine with ropivacaine. In this study we tried to compare efficacy and clinical characteristics of isobaric forms of intrathecal levobupivacaine 0.5% and ropivacaine 0.75% in lower abdominal surgeries.This prospective, observational and open labeled, comparative study done for a period of one year in a tertiary care health centre, in South India, prior approval from Institutional ethics committee was taken. 60 patients were included and each of 60 patients was randomized (sealed, numbered and opaque envelopes) to one of two groups of 30 patients. Each of the patients enrolled in the study received one of two solutions: levobupivacaine or Ropivacaine, patient was turned supine immediately after injection, time of which was defined as ‘zero’. Thereafter, investigator, assessed upper and lower limits of sensory block (analgesia to pinprick), degree of motor block and recorded heart rate and arterial pressure. The patients were then transferred into the operating theatre and assessments were continued at 30 min intervals thereafter until complete motor and sensory blocks regression. Data were analysed using a standard computer-based statistics package.Mean time of onset of sensory blockade for levobupivacaine was 3.85±0.5 min and in Ropivacaine was 3.90 ± 0.6 min. Mean time of onset of motor blockade in levobupivacaine group was 3.65 ± 0.72 min and in Ropivacaine group was 3.82 ± 0.88 min, mean duration of motor blockade in Levobupivacaine group was 201.15±22.06 min and in Ropivacaine group was 204 ± 21.20 min. Mean time for regression for levobupivacaine was 98.27±10.18 min and for ropivacaine was 96.33 ±8.21min. There is no significant difference, Mean time for first request of analgesic for Levobupivacaine was 262.22 ±36.60 and for Ropivacaine was 261.20 ± 32.71 min. There is no statistically significant difference; there was no statistically significant difference in the incidence of adverse events in both the groups. So both the drugs are considered to be safe in spinal anesthesia.In conclusion, Ropivacaine and Levobupivacaine has similar onset of sensory and motor blockade with comparable hemodynamic parameters and time for rescue analgesic administration was comparable between two groups and incidence of post- operative complications is not significant with both drugs.