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Hyperbaric 0.5% Levobupivacaine with Bupivacaine 0.5% for Spinal Anaesthesia in Elective Surgeries

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Background: Subarachnoid block is popular and commonly used worldwide. The advantage of an awake patient, minimal drug cost and rapid patient turnover has made this the method of choice for many surgical procedures. Among the popular drugs used for subarachnoid block are bupivacaine and and its enantiomer Levobupivacaine. Objectives: A clinical study to compare the effect of spinal anaesthesia with 0.5% hyperbaric levobupivacaine and 0.5% hyperbaric bupivacaine in patients undergoing elective below umbilical surgeries. Materials and Methods: 60 patients of American Society of Anaesthesiologists physical status class1 and 2 patients with 18 to 70 years of age posted for elective lower limb surgeries under subarachnoid block technique were randomly assigned into 2 equal groups. Group L received intrathecal hyperbaric 0.5% levo bupivacaine [total 3.5ml], Isobaric levobupivacaine made hyperbaric by adding 0.5ml of 50% dextrose to 3ml of levobupivacaine, Group B received intrathecal 15mg hyperbaric 0.5% bupivacaine with 0.5ml of normal saline.[total 3.5ml]. Results: Group L and Group B had similar onset of sensory blockade. Group L had delayed onset of motor blockade, lesser degree of motor blockade and lesser quality of intraoperative anaesthesia, similar level of sensory and maximum upper spread of sensory blockade, time taken for two segment regression time and duration of motor blockade but shorter duration of analgesia when compared to Group B. Conclusion: Hyperbaric 0.5% bupivacaine remains effective choice than hyperbaric 0.5% levobupivacaine for spinal anaesthesia in elective surgeries, But hyperbaric levobupivacaine is also a better option for shorter procedures and outpatient spinal anaesthesia.

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Background: Subarachnoid block is popular and commonly used worldwide. The advantage of an awake patient, minimal drug cost and rapid patient turnover has made this the method of choice for many surgical procedures. Among the popular drugs used for subarachnoid block are bupivacaine and and its enantiomer Levobupivacaine. Objectives: A clinical study to compare the effect of spinal anaesthesia with 0.5% hyperbaric levobupivacaine and 0.5% hyperbaric bupivacaine in patients undergoing elective below umbilical surgeries. Materials and Methods: 60 patients of American Society of Anaesthesiologists physical status class1 and 2 patients with 18 to 70 years of age posted for elective lower limb surgeries under subarachnoid block technique were randomly assigned into 2 equal groups. Group L received intrathecal hyperbaric 0.5% levo bupivacaine [total 3.5ml], Isobaric levobupivacaine made hyperbaric by adding 0.5ml of 50% dextrose to 3ml of levobupivacaine, Group B received intrathecal 15mg hyperbaric 0.5% bupivacaine with 0.5ml of normal saline.[total 3.5ml]. Results: Group L and Group B had similar onset of sensory blockade. Group L had delayed onset of motor blockade, lesser degree of motor blockade and lesser quality of intraoperative anaesthesia, similar level of sensory and maximum upper spread of sensory blockade, time taken for two segment regression time and duration of motor blockade but shorter duration of analgesia when compared to Group B. Conclusion: Hyperbaric 0.5% bupivacaine remains effective choice than hyperbaric 0.5% levobupivacaine for spinal anaesthesia in elective surgeries, But hyperbaric levobupivacaine is also a better option for shorter procedures and outpatient spinal anaesthesia.

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This page is a summary of: A Comparative Study of Hyperbaric 0.5% Levobupivacaine with Bupivacaine 0.5% for Spinal Anaesthesia in Elective Surgeries, Indian Journal of Anaesthesia and Analgesia, January 2018, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.51218.8.
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