Levobupivacaine versus racemic bupivacaine for extradural anesthesia for cesarean delivery.
OBJECTIVE
Bupivacaine is available as a racemic mixture of dextrobupivacaine and levobupivacaine. Many studies show that dextrobupivacaine has a greater inherent central nervous system and cardiovascular toxicity than levobupivacaine. The aim of the present study was to investigate the clinical efficacy and safety of levobupivacaine compared with racemic bupivacaine for extradural anesthesia. METERIAL AND METHOD: The authors studied 61 patients undergoing elective cesarean delivery who received either 0.5% levobupivacaine (n = 31) or 0.5% bupivacaine (n = 30) extradurally, in a randomized, double blind study.


RESULTS
The 2 groups were similar in terms of time to block suitable for surgery, duration of sensory block, time to T10 regression, time to onset and offset of motor block, verbal numeric pain scores at abdominal opening and at child birth. Mean (SD) dose of 0.5% levobupivacaine and 0.5% bupivacaine were 19.3 (4.6) ml and 17.3 (3.8) ml respectively, p = 0.069.


CONCLUSIONS
Levobupivacaine produces an extradural block that is similar to bupivacaine, and is an alternative to bupivacaine for cesarean delivery patients.
Department of Anesthesiology and Clinical Epidemiology Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Pornswan
P
Ngamprasertwong
Danai
D
Udomtecha
Somrat
S
Charuluxananan
Oraluxana
O
Rodanant
Chaiwat
C
Srihatajati
Sintichai
S
Baogham
D000328:Adult; D000773:Anesthesia, Obstetrical; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000627:therapeutic use*; D002585:Cesarean Section; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007268:Injections, Epidural; D000077554:Levobupivacaine; D009407:Nerve Block / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy*; D011247:Pregnancy; D012449:Safety; D016896:Treatment Outcome
D000779:Anesthetics, Local; D000077554:Levobupivacaine; D002045:Bupivacaine