The comparison of the effect of intrathecal levobupivacaine and bupivacaine for ano-rectal surgery

Abstract

Objectives: Spinal anesthesia is widely used for ano-rectal surgery. We aimed to compare the anesthetic potencies and hemodynamic effects of levobupivacaine and bupivacaine with fentanil intrathecally administered in patients undergoing ano-rectal surgery. Materials and methods: After Dicle University Medical Faculty Research Hospital ethical committee approval and written consent of the patients who underwent anorectal surgery were obtained, sixty patients between the ages of 18-65 with ASA I-II were enrolled in this study. The patients were randomly allocated to two groups; Group I recived 9 mg bupivacaine 0.5% and 20 mcg fentanil (total 2 ml), and Group II received 9 mg levobupivacaine 0.5% and 20 mcg fentanyl (total 2.6 ml). Spinal anesthesia was performed using a 26 G spinal needle via the L4-5 lumbar intervertebral space. Patients’ grade of sensory block was assessed with pin prick test, and the grade of motor block was assessed with bromage scale. Hemodynamic data were also recorded. Results: Two segment regression time and of sensory block onset time are similar between the groups. Motor block onset time was longer in bupivacaine group than levobupivacaine group but motor block regression time was shorter in group levobupivacaine. Hemodynamic parameters were similar in both groups. Conclusions: Our results shows that levobupivacaine which has similar features with bupivacaine in terms of sensory block may be a good alternative to bupivacaine in the operations in which development of the motor blocks is unwanted.