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A comparative study of the anesthetic potencies and hemodynamic changes of 0.5% isobaric levobupivacaine and 0.5% hyperbaric racemic bupivacaine for spinal anesthesia in lower abdominal and lower limb surgeries

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Original Article

Author Details : Arun Kumar Balasubramanian, Naveena Pandian*, Brindha Rathnasabapathy, Elvis Senthil, Shankar Radhakrishnan

Volume : 7, Issue : 3, Year : 2020

Article Page : 450-456

https://doi.org/10.18231/j.ijca.2020.082

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Abstract

Background: Spinal anesthesia is a preferable technique for lower abdominal surgeries as it provides
effective sensory and motor block with rapid onset, attenuation of stress response and less thromboembolic
episodes. It is currently known that levobupivacaine and racemic bupivacaine have similar analgesic
potencies for epidural and spinal anesthesia. Due to the adverse cardiac effects of racemic bupivacaine,
several studies have been performed in order to find anesthetic compounds to take its place.
Aim: To compare and evaluate the efficacy between 0.5% isobaric Levobupivacaine and 0.5% racemic
Bupivacaine in spinal anesthesia among the patients undergoing lower abdominal and lower limb surgeries.
Materials and Methods: A prospective comparative study was conducted for a period of one year at our
hospital under the department of anesthesia. Based on purposive sampling 200 subjects were selected for
the study and were divided into two groups. The study subjects were randomly allocated into two groups
of 100 each. Group B subjects received 3ml of 0.5% intrathecal hyerbaric Bupivacaine (15 mg) and group
L patients received .5% intrathecal Isobaric Levobupivacaine (15 mg). The mode of onset and the duration
of motor and sensory block were assessed and the subjects were monitored for blood pressure, peripheral
oxygen saturation (SpO2), and pulse rate at 1st, 3rd, and 5th min and every 5 min up to the 30th min, and
then every 10 min until the end of the operation.
Results: The onset and the duration of motor and sensory block did not show statistical significant
difference between the bupivacaine and levobupivacaine. The incidence of hypotension and bradycardia
was more among the bupivacaine group than that of the levobupivacaine group and the difference was found
to be statistically significant (p<.05), whereas the incidence of nausea, vomiting or respiratory depression
did not show a statistical significant difference between the two groups.
Conclusion: Levobupivacaine with the same potency and lesser cardiovascular side effects could be
considered as a better alternative for bupivacaine.

Keywords: Bupivacaine, Levobupivacaine, Sensory and motor block, Hemodynamic effects.

How to cite : Balasubramanian A K , Pandian N , Rathnasabapathy B , Senthil E , Radhakrishnan S , A comparative study of the anesthetic potencies and hemodynamic changes of 0.5% isobaric levobupivacaine and 0.5% hyperbaric racemic bupivacaine for spinal anesthesia in lower abdominal and lower limb surgeries. Indian J Clin Anaesth 2020;7(3):450-456

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