Levobupivacaine vs Ropivacaine in Spinal Anesthesia for Lower Abdominal and Lower Limb Surgeries: A Comparative Study

Abstract

Background: Till recently Bupivacaine 0.5% Heavy was the only drug used for spinal anesthesia after the discontinuation of Lidocaine’s intrathecal use. The last few years, its pure S (-) enantiomers, ropivacaine and levobupivacaine, have been introduced into clinical practice because of their lower cardiac and central nervous system toxic effects. This study was performed to compare the anesthetic efficacy and safety of the ropivacaine and levobupivacaine, in patients undergoing lower abdominal and lower limb surgery. Methods: 60 patients of ASA physical status I–II between the ages of 20–60 years, scheduled for spinal anesthesia were prospectively enrolled in our randomized controlled trial. They were divided into 2 groups, R and L, of 30 pts each. 3.0ml (15mg) of 0.5% isobaric ropivacaine in study group R and 3.0ml (15mg) of 0.5% isobaric levobupivacaine in study group L was given. Results: The mean Time of onset sensory blockade and Time of onset of Motor Blockade was significantly high in Group R as compare to Group L, whereas mean Duration of sensory blockade, mean Duration of motor blockade and mean Duration of analgesia were significantly less in Group R as compare to Group L (P<0.001). Conclusion: Intrathecal administration of either 15 mg ropivacaine or 15 mg levobupivacaine was well-tolerated and provided similar, effective anesthesia for lower limb and lower abdominal surgery. Intrathecal ropivacaine may prove useful when surgical anesthesia of a similar quality but of a shorter duration is desired.