Comparison of Epidural Levo Bupivacaine (0.5%) with Racemic Bupivacaine (0.5%) for Lower Abdominal Surgery

ABSTRACT

Introduction: Levobupivacaine, the pure S (-) isomer ofbupivacaine, is attributed to have less cardiotoxicity whencompared to racemic bupivacaine. Levobupivacaine increasethe margin of safety for epidural anaesthesia. Study aimed toinvestigate the clinical efficacy of levoupivacaine comparedwith racemic bupivacaine for epidural anaesthesia.Material and Methods: We conducted an observationalmulticentric study comparing sensory and motor blockproduced by 0.5% levobupivacaine (17 ml, 85 mg) withthat of 0.5% racemic bupivacaine in 60 patients undergoingelective lower abdominal surgery under epidural anaesthesia.Result: No statistically significant difference was foundbetween the groups in terms of sensory and motor blockade.The time to onset of adequate sensory block (T10dermatome)was similar in both treatment groups (6.20+/-2.23 min forlevobupivacaine and 6.17+/-2.61 min for bupivacaine).Average peak block height reached was T4 for both group.Time for sensory block to reach T6 level was comparable.(10.97+/-2.89 for bupivacaine and 11.23 +/-5.99 forlevobupivacaine.) Time for regression of sensory block to T10level was similar (224.17+/-30 for bupivacaine and 224.83 +/-23 for levobupivacaine). There was no difference in theonset and intensity of motor block between two groups.Conclusion: 0.5% levobupivacaine and 0.5% bupivacaineproduced effective epidural anaesthesia and their effects wereclinically indistinguishable. Levobupivacaine could be a goodalternative to bupivacaine in patients administered epiduralanaesthesia