Randomized controlled study comparing a isobaric levobupivacaine to a conventional dose of hyperbaric bupivacaine for infra umbilical surgeries

Abstract

Levobupivacaine is an attractive alternative to racemic bupivacaine for spinal anesthesia due to the lower potential for cardio-toxicity and faster recovery profile. Present study is undertaken to compare hemodynamic and analgesic characteristics using an isobaric levobupivacaine to a conventional dose of hyperbaric bupivacaine for infra umbilical surgeries. A prospective randomized double blind study was conducted involving 60 patients belonging to ASA gr I & II coming for elective lower abdominal surgeries. They were randomly divided into 2 groups of 30 each. Group I received 3ml of 0.5% hyperbaric bupivacaine, group II received 3ml of 0.5% isobaric levobupivacaine. Hemodynamic parameters like heart rate, NIBP and SpO2 were monitored every 15mins till end of surgery and for 2 hours post operatively. Incidence of side effects such as hypotension, bradycardia and nausea and vomiting were noted. Demographic parameters in both groups were comparable. Onset of sensory block was slow in group L . Level of sensory block was comparable and duration of analgesia at L1(L1regression) was significantly shorter with Levobupivacaine compared to Bupivacaine. Onset of motor blockade was slower and duration of motor blockade was also shorter with levobupivacaine compared to bupivacaine. However all the patients in either group attained complete motor blockade.