A Comparative Evaluation of Isobaric Levobupivacine Versus Hyperbaric Bupivacaine for Elective Lower Limb Orthopedic Surgeries Under Spinal Anaesthesia

Nazeera Banu, C (2021) A Comparative Evaluation of Isobaric Levobupivacine Versus Hyperbaric Bupivacaine for Elective Lower Limb Orthopedic Surgeries Under Spinal Anaesthesia. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.


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BACKGROUND: Levobupivacaine is an S (-) enantiomer of bupivacaine having les cardiotoxic and central nervous system effects. Use of isobaric levobupivacaine in spinal anesthesia has recently been started. This study was designed to compare the clinical efficacy of equal doses of 0.5% hyperbaric bupivacaine with 0.5% isobaric Levobupivacaine for lower limb orthopaedic surgeries under spinal anaesthesia. MATERIALS AND METHODS: Sixty American Society of Anesthesiologists grade I-II patients undergoing elective lower limb orthopaedic surgeries under spinal anaesthesia were recruited and randomized to receive 3ml of 0.5% (15 mg) isobaric Levobupivacaine in Group L or 3ml of 0.5% (15 mg) hyperbaric Bupivacaine containing dextrose 80 mg/ml in Group B. Monitoring of vitals and observation for the block parameters were carried out. The data were presented as mean with a standard deviation and frequency with percentage. Statistical analysis was performed using InStatcomputer software with appropriate tests and P< 0.05 was considered to be significant. RESULTS: Levobupivacaine produced a slower onset of sensory block (7.93 ± 6.69 min; Bupivacaine 5.20 ± 0.71 min ;P< 0.05) and themean total duration of sensory block was significantly lesser ( Levobupivacaine 183.47 ± 4.71 min ; Bupivacaine 211.83 ± 4.79 min ). Both groups were comparable regarding SBP, DBP, HR, SpO2. However incidence of hypotension and bradycardia was significantly more in group B than in group L. Duration of analgesia and sensory blockade were significantly longer in group B than group L, p <0.0001 and p= 0.0014 respectively while motor blockade was comparable, p = 0.21. CONCLUSION: Isobaric levobupivacaine offering effective sensory motor blockage and stable hemodynamic profile with significantly decreased cardiovascular and central nervous system toxicity is a suitable alternative to hyperbaric bupivacaine in spinal anesthesia for lower limb orthopedic surgeries. Nevertheless hyperbaric bupivacaine is recommendable for surgery requiring higher sensory blockade, longer duration and emergency operations.

Item Type: Thesis (Masters)
Additional Information: 201820706
Uncontrolled Keywords: Intrathecal, bupivacaine, levobupivacaine, orthopaedic surgery.
Subjects: MEDICAL > Anaesthesiology
Depositing User: Subramani R
Date Deposited: 17 May 2021 17:10
Last Modified: 08 Jan 2022 12:06
URI: http://repository-tnmgrmu.ac.in/id/eprint/16992

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