Abstract

*Dr. Gautam Singh, Dr. Vasanti Kelkar, Dr. Sanhita Kulkarni, Dr. Prabha Nayak, Dr Anshul Udiavar, Dr Tejas Warkari

ABSTRACT

Background: Levobupivacaine and Ropivacaine are the two recently introduced alternatives to Bupivacaine in clinical practice. We compared the efficacy of intrathecally administered isobaric 0.5% levobupivacaine and isobaric 0.5% ropivacaine in lower limb surgeries in terms of characteristics of sensory and motor blockade and intra-operative haemodynamic stability. Study Design: Prospective, randomized double blind study was carried out in sixty American society of Anaesthesiologists grade 1 – 3 patients in age group of 18 to 65 years having height between 150 - 180 cm undergoing lower limb surgeries. Material and Methods: The patients were divided in 2 groups of 30 patients each. Group-A received 3 ml Isobaric 0.5% Levobupivacaine whereas Group- B received 3 ml Isobaric 0.5% Ropivacaine intrathecally. Onset and duration of sensory and motor blocks, maximum height of sensory block and intraoperative haemodynamic parameters (heart rate and mean blood pressure) were compared. Results: Patients in Levobupivacaine group showed faster onset and longer duration of sensory and motor blocks. The median level of sensory block attained was higher (T6) in Levobupivacaine group than Ropivacaine group (T8). Ropivacaine group showed higher incidence of bradycardia whereas incidence of hypotension was comparable in both the groups. Conclusion: Both isobaric 0.5% Levobupivacaine and isobaric 0.5% Ropivacaine are effective with good haemodynamic stability when used intrathecally. Levobupivacaine has faster and prolonged sensory and motor blockade compared to Ropivacaine. While Ropivacaine can be a better drug for day care surgeries, Levobupivacaine is better for surgeries of prolonged duration.