Levobupivacaina, bupivacaina racemica e ropivacaina nel blocco del plesso brachiale.
BACKGROUND
To compare clinical profiles of levobupivacaine, racemic bupivacaine and ropivacaine at equipotent doses in axillary brachial plexus block in the orthopaedic surgery of wrist and hand.


METHODS
For this prospective, open randomised study we took on 45 patients of both sexes, ASA I-III, subdivided into three groups in which, respectively, axillary brachial plexus block was performed, with ENS, using levobupivacaine 0.50% (1 mg/kg), racemic bupivacaine 0.50% (1 mg/kg) and ropivacaine 0.75% (1.4 mg/kg). The onset of sensory and motor block, their duration, onset of surgical block, anaesthetic plane and possible adverse events were recorded.


RESULTS
The duration of sensory block was longer in group of patients treated with levobupivacaine than in two other groups. Surgical onset was similar for levobupivacaine and ropivacaine, but it was delayed for racemic bupivacaine. In group of patients who received racemic bupivacaine, two episodes of reduction in heart rate without significant hypotension have been observed. The anaesthetic plan was satisfactory in the all three groups of patients.


CONCLUSIONS
In our experience levobupivacaine has been demonstrated to be a good substitute for racemic bupivacaine. Compared to ropivacaine, levobupivacaine induces a longer duration of postsurgery analgesia and, in our opinion, this datum seems to be the most significant.
Cacciapuoti
A
A
Service of Anesthesia, Resuscitation, Pain Therapy and Hyperbaric Medicine, S. Antonio Abate Hospital, Trapani, Italy.
Castello
G
G
Francesco
A
A
D000328:Adult; D000368:Aged; D000577:Amides / Q000009:adverse effects; D000779:Anesthetics, Local / Q000009:adverse effects / Q000737:chemistry; D001917:Brachial Plexus; D002045:Bupivacaine / Q000009:adverse effects / Q000737:chemistry; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D011446:Prospective Studies; D000077212:Ropivacaine; D013237:Stereoisomerism
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D002045:Bupivacaine