COMPARISON OF THE EFFECT OF INTRATHECAL 0.5 % ISOBARIC BUPIVACAINE AND 0.5% ISOBARIC LEVOBUPIVACAINE IN PATIENTS UNDERGOING LOWER ABDOMINAL AND LOWER LIMB SURGERIES

BACKGROUND AND OBJECTIVESLevobupivacaine, a new local anaesthetic, has been recently introduced into clinical practice because of its lower toxic effects for heart and central nervous system.It has been already investigated in epidural and local-regional techniques, but more has to be known regarding its characteristics in spinal anaesthesia.The aim of our study was to compare clinical and anaesthetic features of levobupivacaine and isobaric bupivacaine when intrathecally administered in 100 patients undergoing lower abdominal and lower limb surgeries. METHODS2.5 mL of glucose-free levobupivacaine 0.5% (Group L) or 2.5 mL of isobaric bupivacaine 0.5% (Group B) was administered in 50 patients each.Sensory and motor blockade evaluated by the pinprick test and a modified Bromage score respectively.Vital parameters, intraoperative VAS were recorded as well. RESULTSNo statistically significant differences between groups were observed in either anaesthetic potencies.Nevertheless, spinal puncture was accompanied by hypotension in 3 patients and bradycardia in 2 patients of group B, and hypotension in 6 patients and bradycardia in 3 patients in group L. In both cases, haemodynamics were promptly and successfully treated, with no sequelae. CONCLUSIONIn conclusion, levobupivacaine although has no added advantage over isobaric bupivacaine but having lesser CNS and cardiac effects after accidental intravascular injection, is an interesting alternative to bupivacaine for spinal anaesthesia in lower abdominal and lower limb surgeries.