title: Low-dose ropivacaine or levobupivacaine walking spinal anesthesia in ambulatory inguinal herniorrhaphy.
abstract: OBJECTIVE
  The purpose of our study was to compare the equipotent doses of ropivacaine and levobupivacaine for walk-out criteria and the characteristics of spinal anesthesia in inguinal herniorrhaphy surgery.
  
  
  METHODS
  Combined spinal-epidural anesthesia was performed. Adult patients were randomly allocated to receive 5 mg 0.5% ropivacaine plus 25 μg fentanyl (group RF, n = 25) or 3.75 mg 0.75% levobupivacaine plus 25 μg fentanyl (group LF, n = 25). Each solution was hypobaric, and the same volume, 3 ml, was administered. Sensory and motor block characteristics, hemodynamic changes, side effects, number of patients having ability to stand and walk at the end of the operation, time to first analgesic requirement, time to urination, time to getting out of bed (ambulation), and time to home discharge were determined.
  
  
  RESULTS
  Sensory block onset time and time to reach the T6 dermatome were significantly shorter in group LF, whereas time to the two-segment regression and time to first analgesic requirement were significantly shorter in group RF. All patients in group LF were Bromage 0. Time to home discharge was shorter in group LF, but this difference was not statistically significant.
  
  
  CONCLUSIONS
  We suggest that both local anesthetics can be used in walking spinal technique. Levobupivacaine may be an alternative local anesthetic for walking spinal anesthesia as it provides minimum motor block and a long duration of postoperative analgesia, even if its use is not associated with a shorter home discharge time.
authors.affiliation: Ankara Numune Training and Research Hospital, Samanpazarı, Ankara 06100, Turkey. okantaspinar@yahoo.com
authors.forename: Vildan
authors.initials: V
authors.lastname: Taspinar
authors.forename: Altan
authors.initials: A
authors.lastname: Sahin
authors.forename: Nezihe F
authors.initials: NF
authors.lastname: Donmez
authors.forename: Yasar
authors.initials: Y
authors.lastname: Pala
authors.forename: Aydin
authors.initials: A
authors.lastname: Selcuk
authors.forename: Murat
authors.initials: M
authors.lastname: Ozcan
authors.forename: Bayazit
authors.initials: B
authors.lastname: Dikmen
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D000577:Amides / Q000008:administration & dosage / Q000494:pharmacology*; D000767:Anesthesia, Epidural; D000775:Anesthesia, Spinal; D000779:Anesthetics, Local / Q000494:pharmacology*; D002045:Bupivacaine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000494:pharmacology; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D000077554:Levobupivacaine; D008297:Male; D008875:Middle Aged; D000077212:Ropivacaine
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D000077212:Ropivacaine; D000077554:Levobupivacaine; D002045:Bupivacaine