ABSTRACT
Background and Aims: Levobupivacaine is a relatively new long-acting local anesthetic, which is the isolated S-enantiomer of racemic bupivacaine with less cardiotoxicity and neurotoxicity than bupivacaine. Although it has been introduced for routine epidural anesthesia, yet there is inadequate data for its use in infra-umbilical surgery under spinal anesthesia. We therefore performed this prospective randomized double-blinded study to evaluate the anesthetic potencies and hemodynamics of intrathecal levobupivacaine compared with racemic bupivacaine
Methodology: A prospective randomized comparative double blind study included 100 patients, American Society of Anesthesiologists [ASA] I-II, scheduled for elective infra-umbilical surgeries under spinal anesthesia was done. The patients were divided into two groups which received either 3.5 ml levobupivacaine 0.5% isobaric or 3.5 ml bupivacaine 0.5% isobaric for spinal anesthesia. The measurement included vital signs, motor and sensory blockade and side effects
Results: There was no significant difference between the two groups in the quality of motor and sensory block [p-value > 0.05]. Maximum number of patients [60%] in levobupivacaine group had sensory onset time between 1-5 minutes whereas in bupivacaine group, 56% of patients had sensory onset time of 6-10 min, which was statistically significant [p=.0001]. Nausea, vomiting and shivering was more in Group B patients
Conclusion: The present study indicated that levobupivacaine is a valid alternative to racemic bupivacaine for spinal anesthesia. Both the drugs have similar clinical profile, requirement of rescue analgesic and side effect such as hemodynamic changes, nausea and vomiting
ABSTRACT
To compare the recovery characteristics of selective spinal anaesthesia [SSA] with propofol based GA for short duration outpatient gynaecological laparoscopic surgeries. Prospective, randomized clinical trial. Department of Anaesthesiology and Intensive Care, Maulana Azad Medical College, New Delhi, India. Conducted from August 2007 to March 2008. This trial was done in forty adult female patients who were randomized in two groups: Group GA: GA was induced with intravenous fentanyl [2microg/kg] and propofol [2mg/kg]. Airway was secured with proseal laryngeal mask airway. Anaesthesia was maintained with titrated propofol infusion [100-150microg/kg/min], nitrous oxide and oxygen [50:50]. Group SSA: Patients received subarachnoid block in sitting position with lignocaine 10mg and sufentanyl 10microg to a total volume of 2.5mL with sterile water. Patient remained sitting for 1minute and then in reverse Trendelenburg position for 6-8minutes. Recovery time from the end of surgery and any adverse effects were recorded. Patients demographic profile and duration of surgery were comparable. The time from the end of surgery to exit from operating room, time to straight leg raising and deep knee bend were significantly prolonged in group GA as compared to group SSA. The time to reach a modified Aldrete score>9 was significantly prolonged in group GA as compared to group SSA. The mean time to first analgesic requirement postoperatively was significantly longer for group SSA as compared with group GA. SSA could effectively be used for patients undergoing short duration outpatient gynecological laparoscopy as compared to propofol infusion based general anaesthesia