A randomized, prospective, comparative study to evaluate the motor blockade properties of 3ml of 0.5% isobaric levobupivacaine and 3ml of 0.5% isobaric ropivacaine for spinal anaesthesia in patients undergoing elective lower limb orthopaedic surgeries
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 7, Issue 3
Abstract
Background: Levobupivacaine is S (-) enantiomer of bupivacaine. It is somewhat less cardiotoxic than the racemic bupivacaine. It seems to be an attractive alternative to Bupivacaine. Ropivacaine is a long acting regional anaesthetic that is structurally related to Bupivacaine. It is less lipophilic than Bupivacaine and is less likely to penetrate large myelinated motor fibers. Not many studies have been done in India comparing the use of isobaric Levobupivacaine 0.5% and isobaric Ropivacaine 0.5% for spinal anaesthesia. Hence the present study was undertaken to evaluate the motor blockade properties of 3ml of 0.5% isobaric levobupivacaine and 3ml of 0.5% isobaric ropivacaine for spinal anaesthesia in patients undergoing elective lower limb orthopaedic surgeries. Materials and Methods: Group A (n=30) received Levobupivacaine 0.5% and group B (n=30) Ropivacaine 0.5%. Onset, duration of motor blocks, time for maximum motor block, quality of motor block were recorded. Results: Onset of motor blockade (Levobupivacaine group 4.43±0.858 minutes vs 6.70±1.535 minutes in Ropivacaine) and the time for maximum motor block evobupivacaine group 9.63±1.129 minutes vs 13.20±1.827 minutes in Ropivacaine) between the two groups were statistically significant p values being (p=0.0001) and (p=0.0001) respectively. Twenty patients in Levobupivacaine group had complete motor blockade compared to eighteen patients in Ropivacaine group, which was statistically not significant. The duration of motor blockade in Levobupivacaine group was 222.00±14.716 minutes, whereas the duration of motor block in Ropivacaine was 138.33±12.617 minutes. The duration of motor block were statistically significant between the two groups (p=0.0001 for motor block). Conclusion: 0.5% isobaric Levobupivacaine (15 mg) produced faster onset and prolonged motor blockade compared to 0.5% isobaric Ropivacaine (15 mg) in adult patients undergoing elective lower limb surgeries, without significant haemodynamic changes. Hence Ropivacaine can be a better drug for day care surgeries and Levobupivacaine for prolonged surgeries.
Authors and Affiliations
Prasanna Kumara V R, Suresh S B
Keywords
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