title: Comparative study between Levobupivacaine and Bupivacaine for hernia surgery in the elderly.
abstract: BACKGROUND
  The inguinal hernia is one of the most common diseases in the elderly. Treatment of this type of pathology is exclusively surgical and relies almost always on the use of local anesthesia. While in the past hernia surgery was carried out mainly by general anesthesia, in recent years there has been growing emphasis on the role of local anesthesia.
  
  
  METHODS
  The aim of our study was to compare intra-and postoperative analgesia obtained by the use of levobupivacaine compared with that of bupivacaine. Bupivacaine is one of the main local anesthetics used in the intervention of inguinal hernioplasty. Levobupivacaine is an enantiomer of racemic bupivacaine with less cardiotoxicity and neurotoxicity. The study was conducted from April 2010 to May 2012. We collected data of forty male patients, aged between 73 and 85 years, who underwent inguinal hernioplasty with local anesthesia for the first time.
  
  
  RESULTS
  Minimal pain is the same in both groups. Mild pain was more frequent in the group who used bupivacaine, moderate pain was slightly more frequent in the group who used levobupivacaine, and the same for intense pain. It is therefore evident how Bupivacaine is slightly less preferred after four and twenty four hours, while the two drugs seem to have the same effect at a distance of twelve and forty-eight hours. Bupivacaine shows a significantly higher number of complications, as already demonstrated by previous studies. The request for an analgesic was slightly higher in patients receiving levobupivacaine.
  
  
  CONCLUSIONS
  After considering all these elements, we can conclude that the clinical efficacy of levobupivacaine and racemic bupivacaine are essentially similar, when used under local intervention of inguinal hernioplasty.
authors.affiliation: Department of General, Geriatric, Oncologic Surgery and advanced technologies, University Federico II of Naples, Via Pansini 5, 80131 Naples, Italy. ritacompagna@libero.it
authors.forename: Rita
authors.initials: R
authors.lastname: Compagna
authors.forename: Gabriele
authors.initials: G
authors.lastname: Vigliotti
authors.forename: Guido
authors.initials: G
authors.lastname: Coretti
authors.forename: Maurizio
authors.initials: M
authors.lastname: Amato
authors.forename: Giovanni
authors.initials: G
authors.lastname: Aprea
authors.forename: Alessandro
authors.initials: A
authors.lastname: Puzziello
authors.forename: Carmelo
authors.initials: C
authors.lastname: Militello
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Iacono
authors.forename: Domenico
authors.initials: D
authors.lastname: Prezioso
authors.forename: Bruno
authors.initials: B
authors.lastname: Amato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use; D000704:Analysis of Variance; D000772:Anesthesia, Local; D000779:Anesthetics, Local; D002045:Bupivacaine / Q000031:analogs & derivatives; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000379:methods*; D006801:Humans; D007432:Intraoperative Period; D000077554:Levobupivacaine; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D000779:Anesthetics, Local; D000077554:Levobupivacaine; D002045:Bupivacaine