Vasoconstriction and analgesic efficacy of locally infiltrated levobupivacaine for nasal surgery.
BACKGROUND
In this study, we compared the use of preincisional lidocaine 2% with epinephrine (LA) and levobupivacaine 0.25% plain (LB) for postoperative analgesia and vasoconstriction in patients undergoing nasal surgery.


METHODS
Sixty patients were randomly assigned to receive preincisional local infiltration under general anesthesia. Group LB received levobupivacaine 0.25%, and group LA received epinephrine plus lidocaine 2% (add volume injected). Intraoperative hemodynamic changes, pre- and postoperative hemoglobin and hematocrit values were recorded. Visual analog scale values 30 min and 1, 2, 8, 12, and 24 h postoperatively and the need for rescue analgesic treatment in the first 24 h of all patients was recorded.


RESULTS
At 30 min and 1, 2, 8, and 12 h postoperatively, visual analog scale values were lower in group LB than in group LA (P < 0.0001, P = 0.002, P = 0.023, P < 0.0001, and P = 0.011, respectively). The analgesic requirement was significantly lower in group LB when compared with that in group LA (P = 0.038). Group LB had significant differences between preoperative and postoperative hemoglobin and hematocrit values (P = 0.014 and 0.025). Group LA had significant differences between preoperative and postoperative hemoglobin and hematocrit values (P = 0.031 and 0.024).


CONCLUSIONS
We conclude that postoperative analgesia in nasal surgery with local infiltration of levobupivacaine was significantly more potent and longer lasting than that achieved by lidocaine plus epinephrine.
Demiraran
Yavuz
Y
Department of Anesthesiology, Faculty of Medicine, University of Duzce, Duzce, Turkey. demiryvz@yahoo.com
Ozturk
Ozcan
O
Guclu
Ender
E
Iskender
Abdulkadir
A
Ergin
Mehmet Hakan
MH
Tokmak
Abdurahman
A
D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D000779:Anesthetics, Local / Q000008:administration & dosage*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004724:Endoscopy / Q000009:adverse effects; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D000077554:Levobupivacaine; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000098:blood supply / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000009:adverse effects*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D011446:Prospective Studies; D012225:Rhinoplasty / Q000009:adverse effects; D013997:Time Factors; D014661:Vasoconstriction / Q000187:drug effects*; D014662:Vasoconstrictor Agents / Q000008:administration & dosage*
D000700:Analgesics; D000779:Anesthetics, Local; D006454:Hemoglobins; D014662:Vasoconstrictor Agents; D008012:Lidocaine; D000077554:Levobupivacaine; D002045:Bupivacaine; D004837:Epinephrine