ABSTRACT
Single enantiomer compounds like levobupivacaine appear to be safe alternative to racemic agents, like bupivacaine for postoperative analgesia. This double-blind randomized dose ranging trial amed to compafe the efficacy sna safety of three concentration of continuous epidural infusion of levobupivacaine for postoperative analgesia after lower extremity orthopedic surgery. After informed consent, 63 eligible patients were randomized to receive levobupivacaine 0.0625%, 0.125%, or 0.25% as a continuous postoperative epidural infusion. Intraoperatively,vital signs, oxygenation, sensory block level, motor block, and abnormal signs and symptoms were monitored. on and a half (1 1/2) hours after the last intraoperative bolus of levobupivacaine, the epidural infusion was started at a rate of 6/ mL/h for 24 24 hours. Pain intensity and pain reliefscores, using the 10-cm visul analog scale, were assessed postoperatively. The time to first request for analgesia (with morphine or tramadol) and the total rescue doses gicen were recorded. Twenty patients were randomized to Goup A (0.0625%), 22 to Group B (0.125%), and 21 to Group C (0.25%). All three group were similar as to age, gender distribution and baseline physical findings. Pain scores, pain relief, and ie to the first rescue does were not significant different among the three groups. The most common adverse events were fever (8%), hypotensy (3%), and vomiting (2%). one patient developed severe hypotensio probably secondary to inadequately replaced intraoperative blood loss. Levobupivacaine is effective and safe for postoperative analgesia as an epidural infusion at 0.0625%, 0.125%, and 0.25%.