title: Intrathecal bupivacaine or levobupivacaine: which should be used for elderly patients?
abstract: OBJECTIVE
  To compare two intrathecal anaesthetics, bupivacaine and levobupivacaine, for their effects on motor and sensory blockade and haemodynamics in patients aged ≥ 65 years undergoing transurethral resection of the prostate (TUR-P) or transurethral resection of the urinary bladder (TUR-M).
  
  
  METHODS
  Patients scheduled to undergo TUR-P or TUR-M were randomized to receive either 3 ml (15 mg) 0.5% isobaric levobupivacaine (group L) or 3 ml (15 mg) of 0.5% hyperbaric bupivacaine (group B) for spinal anaesthesia. The onset time, maximum level and time to reach the maximum level of sensory and motor blockade were recorded. Changes to haemodynamic parameters were also recorded.
  
  
  RESULTS
  The study randomized 100 patients: 57 to group L and 43 to group B. Levobupivacaine did not cause any significant changes in haemodynamic parameters, including systolic blood pressure, and showed a similar sensory block onset time compared with bupivacaine, but it had a significantly longer motor block onset time compared with bupivacaine.
  
  
  CONCLUSIONS
  These current findings suggest that levobupivacaine can be used as a substitute for bupivacaine for spinal anaesthesia in elderly patients ≥ 65 years of age undergoing elective TUR-P or TUR-M operations.
authors.affiliation: Department of Anaesthesiology and Reanimation, Faculty of Medicine, Akdeniz University, Antalya, Turkey.
authors.forename: Demet
authors.initials: D
authors.lastname: Gulec
authors.forename: Bilge
authors.initials: B
authors.lastname: Karsli
authors.forename: Fatma
authors.initials: F
authors.lastname: Ertugrul
authors.forename: Zekiye
authors.initials: Z
authors.lastname: Bigat
authors.forename: Nurten
authors.initials: N
authors.lastname: Kayacan
mesh_terms: D000368:Aged; D000375:Aging; D000775:Anesthesia, Spinal / Q000379:methods*; D000779:Anesthetics, Local / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002045:Bupivacaine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D007278:Injections, Spinal; D000077554:Levobupivacaine; D008297:Male; D009407:Nerve Block / Q000379:methods; D011467:Prostate / Q000601:surgery; D020728:Transurethral Resection of Prostate; D001743:Urinary Bladder / Q000601:surgery
chemical_list: D000779:Anesthetics, Local; D000077554:Levobupivacaine; D002045:Bupivacaine
keywords: Elderly patients; bupivacaine; levobupivacaine; spinal anaesthesia; transurethral resection