Korean J Anesthesiol.  2018 Jun;71(3):220-225. 10.4097/kja.d.18.27191.

Intrathecal levobupivacaine versus bupivacaine for inguinal hernia surgery: a randomized controlled trial

Affiliations
  • 1Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, India. ajay.ydv2509@gmail.com
  • 2Department of Anesthesiology and Critical Care, Lady Hardinge Medical College, New Delhi, India.

Abstract

BACKGROUND
Levobupivacaine is an attractive alternative to racemic bupivacaine for spinal anesthesia due to the lower potential for cardio-toxicity and faster recovery profile. This study was designed to compare isobaric levobupivacaine with hyperbaric racemic bupivacaine with respect to intraoperative quality of anesthesia and the postoperative recovery profile in patients undergoing inguinal hernia surgery.
METHODS
A total of 100 American Society of Anesthesiologists 1 and 2 patients, aged 18-60 years, undergoing elective daycare unilateral inguinal hernia surgery, were randomized into two groups. Group L received spinal anesthesia with 3 ml of 0.5% plain levobupivacaine. Group B received 3 ml of 0.5% hyperbaric racemic bupivacaine. Quality of anesthesia, sensory and motor block characteristics, duration of effective analgesia, time to mobilization, and incidence of side effects were compared.
RESULTS
The quality of anesthesia was comparable between the two groups. No difference was observed in the block onset time or maximum block height. The duration of anesthesia was significantly shorter in group L compared with that in group B (206.2 ± 18.9 min vs. 224.1 ± 15.6 min, P < 0.001), as was duration of motor block (185.9 ± 20.3 min vs. 196.4 ± 21.2 min, P = 0.016) and time to walk unaided (321.9 ± 19.2 min vs. 356.7 ± 26.6 min, P < 0.001). The incidence of hypotension was less in group L (12%) compared to group B (32%) (P = 0.028).
CONCLUSIONS
Levobupivacaine is an effective alternative to bupivacaine for patients undergoing unilateral inguinal hernia surgery. It has a shorter duration of sensory and motor block, allowing earlier mobilization in daycare surgeries, and a lower incidence of intraoperative hypotension.

Keyword

Bupivacaine; Levobupivacaine; Spinal anesthesia

MeSH Terms

Analgesia
Anesthesia
Anesthesia, Spinal
Bupivacaine*
Hernia, Inguinal*
Humans
Hypotension
Incidence
Bupivacaine
Full Text Links
  • KJAE
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
    DB Error: unknown error