title: A comparison of levobupivacaine 0.5% and racemic bupivacaine 0.5% for extradural anesthesia for caesarean section.
abstract: OBJECTIVE
  Bupivacaine is available as a racemic mixture of its enantiomers, dextrobupivacaine and levobupivacaine. Both in vitro and in vivo studies show that dextrobupivacaine has a greater inherent central nervous system (CNS) and cardiovascular toxicity than levobupivacaine. Clinical studies show levobupivacaine to have similar local anesthetic potency to the racemate. The aim of this study was to investigate the clinical efficacy and safety of levobupivacaine compared with racemic bupivacaine for extradural anesthesia.
  
  
  METHODS
  We studied 62 patients undergoing elective caesarean delivery who received 25 mL of either levobupivacaine 0.5% or bupivacaine 0.5%, extradurally, in a randomized, double-blind study.
  
  
  RESULTS
  The 2 groups were similar in terms of time to block suitable for surgery, segmental spread, and duration of sensory block. However, lower-limb motor block was significantly longer in the levobupivacaine group but of significantly less intensity.
  
  
  CONCLUSIONS
  Levobupivacaine produces an extradural block that is similar to bupivacaine, and is a suitable local anesthetic agent for caesarean delivery.
authors.affiliation: Department of Anaesthesia, St. John's Hospital, Livingston, Scotland, UK. faccenda@ualberta.ca
authors.forename: Kathryne A
authors.initials: KA
authors.lastname: Faccenda
authors.forename: Alison M
authors.initials: AM
authors.lastname: Simpson
authors.forename: Duncan J
authors.initials: DJ
authors.lastname: Henderson
authors.forename: Drew
authors.initials: D
authors.lastname: Smith
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: McGrady
authors.forename: Lachlan M M
authors.initials: LM
authors.lastname: Morrison
mesh_terms: D000293:Adolescent; D000328:Adult; D000767:Anesthesia, Epidural / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000779:Anesthetics, Local / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use; D001034:Apgar Score; D002045:Bupivacaine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000097:blood / Q000627:therapeutic use*; D002585:Cesarean Section; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D000077554:Levobupivacaine; D010146:Pain / Q000517:prevention & control*; D011247:Pregnancy; D013237:Stereoisomerism; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000779:Anesthetics, Local; D000077554:Levobupivacaine; D002045:Bupivacaine