A prospective, randomized, double-blind comparison of epidural levobupivacaine 0.5% with epidural ropivacaine 0.75% for lower limb procedures.
OBJECTIVE
This prospective, randomized, observer-blinded study compared onset time and duration of epidural anaesthesia produced by with levobupivacaine and ropivacaine for lower limb surgery.


METHODS
ASA I-III adult patients undergoing elective lower limb procedures were randomized to receive epidural levobupivacaine 0.5% 15 mL (n = 30) or epidural ropivacaine 0.75% 15 mL (n = 35). A blinded observer evaluated onset time and regression of motor and sensory block, and intraoperative needs for fentanyl supplementation (0.1 mg intravenously).


RESULTS
With levobupivacaine, onset time was 29 +/- 24 min, with ropivacaine it was 25 +/- 22 min (P = 0.41). Complete resolution of motor block required 105 +/- 63 min with levobupivacaine and 95 +/- 48 min with ropivacaine (P = 0.86). The time for regression of sensory block to T12 was 185 +/- 77 min with levobupivacaine and 201 +/- 75 min with ropivacaine (P = 0.46). Analgesic supplementation was required in one patient receiving levobupivacaine (3.5%) and in two patients receiving ropivacaine (5.7%) (P = 0.99).


CONCLUSIONS
In adults undergoing lower limb surgery, levobupivacaine 0.5% 15 mL produces an epidural block with the same clinical profile as ropivacaine 0.75% 15 mL.
Peduto
V A
VA
University of Perugia, Department of Medicina Clinica e Sperimentale, Policlinico Monteluce, Perugia, Italy.
Baroncini
S
S
Montanini
S
S
Proietti
R
R
Rosignoli
L
L
Tufano
R
R
Casati
A
A
D000328:Adult; D000577:Amides / Q000008:administration & dosage / Q000627:therapeutic use*; D000704:Analysis of Variance; D000767:Anesthesia, Epidural / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D000077554:Levobupivacaine; D035002:Lower Extremity / Q000601:surgery*; D008297:Male; D009068:Movement / Q000187:drug effects; D010146:Pain / Q000517:prevention & control*; D011446:Prospective Studies; D000077212:Ropivacaine; D012677:Sensation / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome
D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D000077554:Levobupivacaine; D002045:Bupivacaine