Levobupivacaine and bupivacaine in spinal anesthesia for transurethral endoscopic surgery.
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 objective of the present study was to investigate the clinical efficacy and safety of isobaric solution of levobupivacaine compared with hyperbaric solution of racemic bupivacaine in spinal anesthesia.


METHODS
The authors studied 70 patients undergoing elective transurethral endoscopic surgery who received either 0.5% isobaric levobupivacaine (n = 35) or 0.5% hyperbaric bupivacaine (n = 35) intrathecally, in a randomized, double blind study.


RESULTS
The two groups were similar in terms of time to block suitable for surgery, duration of sensory block, time to two segments regression, time to T12 regression, time to onset and offset of motor block, verbal numeric pain scores at the start of the operation and adverse events.


CONCLUSIONS
The present study indicated that 2.5 ml of 0.5% isobaric levobupivacaine and 0.5% hyperbaric of racemic bupivacaine show equally effective potencies for spinal anesthesia, regard to both the onset time and duration of sensory blockade.
Vanna
Opas
O
Department of Anesthesiology, Sappasitthiprasong Hospital, Ubon Ratchatani, Thailand.
Chumsang
Lamai
L
Thongmee
Sarinra
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D000779:Anesthetics, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D004724:Endoscopy; D005260:Female; D006801:Humans; D007022:Hypotension / Q000209:etiology; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012996:Solutions
D000779:Anesthetics, Local; D012996:Solutions; D000077554:Levobupivacaine; D002045:Bupivacaine