Spinal anesthesia for knee arthroscopy using isobaric bupivacaine and levobupivacaine: anesthetic and neuroophthalmological assessment.
BACKGROUND
The aim of the study was to compare the sensory, motor, and neuroophthalmological effects of isobaric levobupivacaine and bupivacaine when intrathecally administered.


METHODS
A prospective, double-blind, randomized study with 60 ASA grade I-II patients aged 18-65 years awaiting knee arthroscopy under spinal anesthesia. Patients received 12.5 mg of isobaric bupivacaine or levobupivacaine. Several features were recorded.


RESULTS
No significant intergroup differences were observed for ASA classification, time to micturate, demographic data, surgery duration, and patient/surgeon satisfaction. Similar hemodynamic parameters and sensory/motor blockade duration were found for both groups. There were no neuroophthalmological effects in either group. Sensory (P = 0.018) and motor blockade onset (P = 0.003) was faster in the bupivacaine group. T6 (T2-T12) and T3 (T2-T12) were the highest sensory block levels for the levobupivacaine and bupivacaine groups, respectively (P = 0.008). It took less time to regain maximum motor blockade in the bupivacaine group (P = 0.014), and the levobupivacaine group required use of analgesia earlier (P = 0.025).


CONCLUSIONS
Isobaric bupivacaine and levobupivacaine are analogous and well-tolerated anesthetics for knee arthroscopy. However, for bupivacaine, sensory and motor blockade onset was faster, and greater sensory blockade with a longer postoperative painless period was achieved.
Department of Anesthesia, University Hospital Virgen de la Arrixaca, Ctra. Madrid-Cartagena, s/n, El Palmar, 30120 Murcia, Spain.
Monica
M
del-Rio-Vellosillo
Department of Ophthalmology and Optometry, School of Medicine, University of Murcia, Avenida Intendente Jorge Palacios 1, 30003 Murcia, Spain ; Department of Ophthalmology, General University Hospital Reina Sofia, Avenida Intendente Jorge Palacios 1, 30003 Murcia, Spain.
Jose Javier
JJ
Garcia-Medina
Department of Anesthesia, University Hospital La Fe, Bulevar del Sur, 46026 Valencia, Spain.
Antonio
A
Abengochea-Cotaina
Department of Ophthalmology, University School of Medicine, University of Valencia, Avenida Blasco Ibáñez 15-17, 46010 Valencia, Spain.
Maria Dolores
0000-0002-0823-8836
MD
Pinazo-Duran
Department of Anesthesia, University Hospital La Fe, Bulevar del Sur, 46026 Valencia, Spain.
Manuel
M
Barbera-Alacreu
D000293:Adolescent; D000328:Adult; D000368:Aged; D000775:Anesthesia, Spinal / Q000379:methods*; D001182:Arthroscopy / Q000379:methods; D002045:Bupivacaine / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D006801:Humans; D007717:Knee / Q000473:pathology / Q000601:surgery*; D000077554:Levobupivacaine; D008875:Middle Aged
D000077554:Levobupivacaine; D002045:Bupivacaine