Levobupivacaine or ropivacaine: A randomised double blind controlled trial using equipotent doses in spinal anaesthesia

详细信息    查看全文

• 作者：Manazir Athar ; Syed Moied Ahmed ; ^{sma99@rediffmail.com" class="auth_mail" title="E-mail the corresponding author} ; Shahna Ali ; Kashmiri Doley ; Ankur Varshney ; Mohd. Masood Hussain Siddiqi
• 关键词：Anesthesia ; spinal ; Anesthetics ; local ; Hemodynamics ; Bupivacaine ; Anesthesia
• 刊名：Colombian Journal of Anesthesiology
• 出版年：2016
• 出版时间：April-June 2016
• 年：2016
• 卷：44
• 期：2
• 页码：97-104
• 全文大小：1034 K

文摘

Levobupivacaine and ropivacaine are relatively new local anaesthetics developed in order to address the issue of bupivacaine toxicity. Although certain differences do exist between their pharmacological profiles, its clinical relevance at equipotent doses is not evident so far.

Objective

To compare the efficacy and characteristics of equipotent doses of intrathecal levobupivacaine with ropivacaine.

Methodology

Sixty ASA grade I/II patients of 18–60 years, either sex posted for lower limb orthopaedic surgery under spinal anaesthesia were randomly given either 15 mg levobupivacaine or 22.5 mg ropivacaine. Sensory and motor block, haemodynamic characteristics, as well as any side effects, were recorded.

Results

Onset of sensory block to T₁₀ was more rapid in group R than group L, p < 0.0001. The median (range) height achieved in group R was T7 (T5–T10) while in group L was T7 (T4–T10). Time to reach maximum height and time to modified Bromage grade 3 was shorter in group R as compared to group L, p < 0.0001. Levobupivacaine produced significantly longer (290.50 ± 34.67) duration of motor block compared to ropivacaine (222.50 ± 23.00). Duration of analgesia was significantly longer in group L (309.83 ± 36.45) than group R (249.50 ± 22.83). No serious adverse effects were recorded.

Conclusion

Levobupivacaine produces significantly longer duration of analgesia than ropivacaine when used in a ratio of 0.6:1. Efficacy, toxicity and haemodynamic profile make ropivacaine suitable agent for surgeries with low threshold for hypotension.