Online ISSN: 2515-8260

Keywords : Motor blockade


A comparison of intrathecal levobupivacaine with hyperbaric bupivacaine for elective caesarean section: A prospective randomized study

Dr MohdMoazzam Mohiuddin Ansari,Dr.Mamidi Ajay Kumar,Dr.KaramthotRavinayak, Dr. Harish Uppala

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10299-10307

Introduction:The subarachnoid block is a safe and time-tested technique for
administering anesthesia for cesarean section due to its rapid onset and effective
sensory and motor blockade. Bupivacaine is available as a racemic mixture of its
enantiomers, dextrobupivacaine and levobupivacaine [1] and is the most frequently used
anesthetic agent for cesarean section.
Aims: This study was performed to compare the anaesthetic efficacy and safety of two
local anaesthetic agents: Hyperbaric Bupivacaine and Isobaric Levobupivacaine, in
patients undergoing elective caesarean section.
Methods and materials: It is prospective study in 100 patients, ASA I-II, were
randomized to receive an intrathecal injection of Hyperbaric Bupivacaine or Isobaric
Levobupivacaine. Group B (n = 50) received 2 ml of Hyperbaric Bupivacaine 5 mg/ml
(10 mg). Group L (n = 50) received 2 ml of Isobaric Levobupivacaine 5 mg/ml (10 mg).
The onset and duration of sensory and motor blockade, recovery parameters,
hemodynamic changes and side effects for the two agents were compared.
Results: The time of onset of sensory block was faster in Group B (1.80 ± 0.404) when
compared with Group L (2.02 ± 0.473). In Group B the time to two segment regression
was prolonged (74.68 ± 12.916) when compared with Group L (69.08 ± 3.349) and it is
statistically significant. Duration of motor blockade was prolonged in Group B (135.52
± 4.781) when compared with Group L (100.04 ± 9.165). Hemodynamic variables were
more stable in Group L than Group B. Twenty patients in Group B had adverse effects
when compared with ten patients in Group L.
Conclusion: 0.5% Isobaric Levobupivacaine 10mg for intrathecal injection of caesarean
section produces adequate sensory and motor blockade and stable hemodynamic
parameters with minimum adverse effects than 0.5% Hyperbaric Bupivacaine 10mg.
We concluded that Isobaric Levobupivacaine is a better alternative for caesarean
section.

Assessment of effectiveness of bupivacaine versus levobupivacaine in supraclavicular brachial plexus block

Kaushikkumar.D.Prajapati, Dinesh Meghjibhai Chaudhary, Nikulbhai Jivanbhai Prajapati

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 671-675

Background:Brachial plexus block is a regional technique commonly employed for upper limb
surgeries. The present study was conducted to assess effectiveness of bupivacaine versus
levobupivacaine in supraclavicular brachial plexus block.
Materials & Methods:70 patients of ASA I & II status were given brachial plexus block by
supraclavicular approach for various upper limb surgeries of both genders. Group I patients
received bupivacaine and group B received levobupivacaine. Onset and duration of sensory
and motor block was recorded. Duration of analgesia was considered as the time taken to
reach an NRS score of 3.
Results: ASA grade I was seen in 25 in group I and 18 in group II and II in 10 in group I and
17 in group II. The mean age was 35.4 years in group I and 35.1 years in group II and weight
was 61.2 Kgs in group I and 62.7 Kgs in group II. The mean onset of sensory block was 12.8
minutes in group I and 10.1 minutes in group II, onset of motor block was 14.9 minutes in
group I and 11.3 minutes in group II, duration of sensory block (minutes) was 812.8 minutes
in group I and 1024.6 minutes in group II, duration of motor block (minutes) was 926.2
minutes in group I and 1156.4 minutes in group II and duration of analgesia (minutes) was
910.2 minutes in group I and 1058.0 minutes in group II. The difference was significant (P<
0.05).
Conclusion: Levobupivacaine has a faster onset of both sensory and motor blockade as
compared to bupivacaine.