EFFICACY OF INTRATHECAL LEVOBUPIVACAINE AND BUPIVACAINE FOR CAESAREAN SECTION- A COMPARATIVE STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 95
Abstract
BACKGROUND Levobupivacaine is the S (-) isomer of bupivacaine, developed as an alternative to bupivacaine for regional anaesthesia after the evidence of its less cardiotoxicity and neurotoxicity. The present study was undertaken to compare the quality of sensory and motor block, haemodynamic changes and side effects if any, following intrathecal levobupivacaine and hyperbaric bupivacaine, in parturients undergoing elective caesarean section. MATERIALS AND METHODS Ninety parturients of ASA status I or II for the elective caesarean section were enrolled in this prospective randomised, doubleblinded study. The parturients were randomly assigned to two groups with patients in Group L (n = 45) and Group B (n = 45). Subarachnoid block was performed with 2.5 mL of 0.5% isobaric levobupivacaine in Group L and 2.5 mL of 0.5% hyperbaric bupivacaine in Group B. Characteristics of sensory and motor block were assessed with pinprick using Hollmen scale and modified Bromage scale, respectively. Side effects such as hypotension, bradycardia, nausea, and vomiting were recorded. Observed data were analysed with the help of Statistical Package for Social Sciences (IBM SPSS software version 20). RESULTS The two study groups were comparable in terms of age, height, body weight and duration of surgery. Patients who received intrathecal levobupivacaine (Group L) experienced effective spinal anaesthesia with significantly late onset of sensory and motor block (5.72 min. vs. 5.13 min.; p=0.001 and 7.0 min. vs. 5.47 min.; p=0.001), but longer duration of analgesia (124.49 min. vs. 120.58 min.; p=0.001) in comparison to the patients who received intrathecal bupivacaine (Group B). Few patients experienced shivering, few reported nausea and vomiting in both groups intraoperatively. CONCLUSION Intrathecal levobupivacaine seems to be an effective alternative to intrathecal bupivacaine in infra-umbilical surgeries like caesarean section with reduced toxic potential and excellent quality of analgesia.
Authors and Affiliations
Amalendu Bikas Chatterjee, Debaleena Jana, Swarup Dutta, Madhab Chandra Mandal, Asish Kumar Paul
Keywords
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- EP ID EP280627
- DOI 10.14260/jemds/2017/1519
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