Levobupivacaine and fentanyl for spinal anaesthesia: a randomized trial.
OBJECTIVE
Levobupivacaine 0.5% and racemic bupivacaine 0.5% are equally effective in spinal anaesthesia. Fentanyl has been used as an adjunct to racemic bupivacaine in spinal anaesthesia. At the time this study was designed, there was no published study on the intrathecal use of 0.5% levobupivacaine with fentanyl.


METHODS
This prospective, randomized, double-blind study compared the clinical efficacy, motor block and haemodynamic effects of using 2.6 mL of 0.5% levobupivacaine alone (25 patients) and 2.3 mL of 0.5% levobupivacaine with fentanyl 15 microg in 0.3 mL (25 patients) for spinal anaesthesia in urological surgery. The study solution was injected into the subarachnoid space at the L3-L4 interspace.


RESULTS
There were no significant differences between the two groups in the haemodynamic changes, and quality of sensory and motor block. Anaesthesia was adequate and patient satisfaction was good in all cases. Side-effects were minor and infrequent with both regimes.


CONCLUSIONS
We conclude that 2.3 mL of 0.5% levobupivacaine with fentanyl 15 microg is as effective as 2.6 mL of 0.5% levobupivacaine alone in spinal anaesthesia for urological surgery. Further studies may be directed to find the optimal combination of levobupivacaine and opioid with maximal haemodynamic stability and least motor block.
Lee
Y Y
YY
Kwong Wah Hospital, Department of Anaesthesiology and Operating Theatre Services, Kowloon, Hong Kong SAR. yylee@ha.org.hk
Muchhal
K
K
Chan
C K
CK
Cheung
A S P
AS
D000759:Adjuvants, Anesthesia; D000368:Aged; D000701:Analgesics, Opioid; D000775:Anesthesia, Spinal; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D001794:Blood Pressure; D002045:Bupivacaine / Q000031:analogs & derivatives; D004311:Double-Blind Method; D005283:Fentanyl; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D009407:Nerve Block; D020728:Transurethral Resection of Prostate; D001749:Urinary Bladder Neoplasms / Q000601:surgery
D000759:Adjuvants, Anesthesia; D000701:Analgesics, Opioid; D019162:Anesthetics, Combined; D000779:Anesthetics, Local; D000077554:Levobupivacaine; D005283:Fentanyl; D002045:Bupivacaine