title: The Comparison of the Effects of Epidural Bupivacaine and Levobupivacaine on the Autonomic Nervous System and Cardiac Arrhythmia Parameters in Inguinal Hernia Surgeries.
abstract: OBJECTIVE
  The aim of this study is to investigate the effects of bupivacaine and levobupivacaine, used to create epidural anaesthesia in inguinal hernia operations, on heart rate variability and cardiac arrhythmia parameters.
  
  
  METHODS
  Sixty male patients of the American Society of Anesthesiology (ASA) I-II group, scheduled to be operated on for inguinal hernia surgery with epidural anaesthesia, were randomly divided into two groups. The patients, with a 12-channel Holter recorder (Rozinn RZ153+12-USA) attached 1 hour before the operation to record until the end of the surgery, were taken into the preparation room and anaesthetised. In group L (n=30), 17 mL of 0.5% levobupivacaine (Chirocain 0.5%-Abbot, El-verum, Norway) was given into the epidural space within 10 minutes, versus 17 mL of 0.5% bupivacaine in (Marcain 0.5%, Astra Zeneca, İstanbul, Turkey) group B (n=30). After 30 minutes, when there was enough block, the operation had been started. Holter recordings, starting 1 hour before the anaesthetic procedure and completed by the end of the operations, were transferred to the computer. The records were evaluated by the cardiologists.
  
  
  RESULTS
  When analysing the frequency effect measurement results of the heart rate variability, it was seen that neither of the medications created any statistically significant change in or among the groups in total, very-low-frequency (VLF), low-frequency (LF), high-frequency (HF) and LF/HF ratio levels. Only normalised low-frequency band was significantly lower in Group L (p=0.013).
  
  
  CONCLUSIONS
  In the volumes and concentrations that were used in our study, levobupivacaine and bupivacaine created sensory blockade at the same level on average and did not reduce heart rate variability at the levels of these blockages.
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Aynur
authors.initials: A
authors.lastname: Demir
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Ayşe Günay
authors.initials: AG
authors.lastname: Kaya
authors.affiliation: Clinic of Cardiology, Keçiören Training and Research Hospital, Ankara, Turkey.
authors.forename: Bünyamin
authors.initials: B
authors.lastname: Yavuz
authors.affiliation: Department of Anaesthesiology and Reanimation, Bozok University Faculty of Medicine, Yozgat, Turkey.
authors.forename: Çiğdem Ünal
authors.initials: ÇÜ
authors.lastname: Kantekin
authors.affiliation: Clinic of Anaesthesiology and Reanimation, Ankara Training and Research Hospital, Ankara, Turkey.
authors.forename: Hülya
authors.initials: H
authors.lastname: Başar
keywords: Anaesthesia; arrhythmia; bupivacaine; epidural; levobupivacaine