A Comparative Clinical Evaluation of Isobaric Levobupivacaine versus Hyperbaric Bupivacaine for Spinal Anaesthesia in Lower Extremity Surgeries

Abstract

Aims and Objective:The present study compares the clinical efficacy of intrathecal 0.5% isobaric levobupivacaine with routinely used intrathecal 0.5% hyperbaric bupivacaine for spinal anaesthesia in lower extremity surgeries. Material and Methods: A prospective, randomized, double blind study at a Tertiary care hospital included one hundred ASA grades I & II patients of either sex in the age range of 20-60 years underwent lower extremity surgeries were divided into two groups. They received 0.5% isobaric levobupivacaine (group L) or 0.5% hyperbaric bupivacvaine (group B), both intrathecally in a 3.25 ml total volume for spinal anesthesia. Parameters observed were onset & duration of sensory and motor block, quality of surgical anaesthesia, hemodynamic parameters, perioperative complications of the patients. Results: Group L had comparable onset of sensory block as compared to group B, [p > 0.05].The motor onset was significantly delayed in group L as compared to group B, [p < 0.05]. The duration of sensory block and motor block was significantly longer in group L as compared to group B, [p<0.05]. The 0.5% isobaric levobupivacaine required significantly longer time to achieve T10 dermatome level and Modified Bromage Scale III as compared to 0.5% hyperbaric Bupivacaine , [p < 0.05]. The hemodynamic stability was better in group L as compared to group B. Conclusion: 0.5% isobaric levobupivacaine provides satisfactory anaesthesia, with better hemodynamic stability, longer duration of sensory and motor block and minimal perioperative complications comparable to routinely used 3.25 ml of 0.5% hyperbaric bupivacaine.Thus it can be used as a safer alternative to 3.25 ml of 0.5% hyperbaric bupivacaine in spinal anaesthesia for elective lower extremity surgeries requiring duration up to 3 hours