Comparison of the effectiveness of intrathecal bupivacaine and levobupivacaine in hip surgery
Abstract
Purpose: We aimed to compare the anesthetic and hemodynamic effects of intrathecally administered levobupivacaine and bupivacaine in combination with fentanyl in hip surgery.
Subjects and methods: Sixty patients categorized as class 1 or 2 according to the American Society of Anesthesiologists (ASA) Physical Status classification, aged between 18 and 65 years and scheduled for hip surgery were randomly assigned to two groups. Patients in Group I received spinal anesthesia with 0.5 % bupivacaine 12.5 mg + fentanyl 10 µg (total 2.6 ml), and patients in Group II received 0.5 % levobupivacaine 12.5 mg + fentanyl 10 µg (total 2.6 ml) intrathecally. The level of sensory block and motor block was evaluated, and hemodynamic data were recorded.
Results: The onset of sensory block and the time to two-segment regression were similar between the two groups. In the levobupivacaine group, the time to motor block onset was longer and the motor block regression time was shorter than that of bupivacaine group. The groups were similar with respect to hemodynamic data.
Conclusion: We consider that levobupivacaine may be a good alternative to bupivacaine, particularly in surgical procedures where less motor block development is desired.
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References
Morrison SG, Dominguez JJ, Frascarolo P, Reiz S. A comparison of the electrocardiographic cardiotoxic effects of racemic bupivacaine, levobupivacaine and ropivacaine in anesthetized swine. Anesth Analg 2000; 90: 1308–14.
Swester S, Olin BR. Drug factors and comparison. 50th ed. Philadelphia: Medical Comp; 1996. p. 285
Glaser C, Marhofer P, Zimpfer G, Heinz MT, Sitzwohl C, Kapral S, et al. Levobupivicaine Versus Racemic Bupivicaine for Spinal Anesthesia. Anesth Analg 2002; 94: 194–8.
Fattorini F, Ricci Z, Rocco A, Romano R, Pascarella MA, Pinto G. Levobupivacaine versus racemic Bupivacaine forspinal anaesthesia in orthopaedic major surgery. Minerva Anestesiol 2006; 72: 637–44.
Lee YY, Muchhal K, Chan CK. Levobupivacaine versus racemic bupivacaine in spinal anaesthesia for urological surgery. Anaesth Intensive Care 2003; 31: 637–41.
Hamber EA, Viscomi CM. Intrathecal lipophilic opioids as adjuncts to surgical spinal anesthesia. Reg Anesth Pain Med 1999; 24: 255–63.
Ben-David B, Miller G, Gavriel R, Gurevitch A. Low-dose bupivacaine-fentanyl spinal anesthesia for cesarean delivery. Reg Anesth Pain Med 2000; 25: 235–39
Siddik-Sayyid SM, Aouad MT, Jalbout MI, Zalaket MI, Berzina CE, Baraka AS. Intrathecal versus intravenous fentanyl for supplementation of subarachnoid block during cesarean delivery. Anesth Analg 2002; 95: 209–13.
Liao RZ, Peng JH, Chen YX, Ou JY, Liang YP, Zhou S, et al. Comparison of the block characteristics of levobupivacaine vs bupivacaine for unilateral spinal block. Di Yi Jun Yi Da Xue XueBao 2005; 25: 1563–7.
Erbay H, Ermumcu O, Hanci V, Atalay H. A comparison of spinal anesthesiae with low-dose hyperbaric levobupivacaine and hyperbaric bupivacaine for transuretral surgery:a randomized controlled trial. Minevra Anestesiologıca 2010; 76: 992–1001
Arslantaş R, Arşlantaş MK, Şitilci T, Akçay E, Uslu N, Kutlu F, et al. Comparison of Intrathecal Levobupivacaine and Isobaric Bupivacaine for Orthopedic Surgery. TARD dergisi 2006; 257: 156–9.
Wojciechowski KG, Avram MJ, Raikoff K, McCarthy RJ, Wong CA. A comparison of epinephrine concentrations in local anesthetic solutions using a “wash” versus measured technique. Anesth Analg 2009; 108: 1243–5.
Dull RO, Peterfreund RA. Variations in the composition of spinal anesthetic solutions: the effects of drug addiction order and preparation methods. Anesth Analg 1998; 87: 1326–30.
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