Online ISSN: 2515-8260

Keywords : Hyperbaric Bupivacaine

To Evaluate Efficacy and Safety of Isobaric Levobupivacaine Versus Hyperbaric Bupivacaine in Lower Limb Orthopaedic Surgeries

Anjani Kumar Singh, Selvakumar Palaniappan, K. Selvaraju

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 310-316

Background: Neuraxial anaesthesia greatly expand the anaesthesiologist
armamentarium in many cases providing alternative to general anaesthesia. Spinal
anaesthesia is a popular technique for lower limb orthopaedic surgeries. Hyperbaric
bupivacaine in 8% glucose is often used. Unintended intravascular injection of
bupivacaine during regional anaesthesia may cause severe cardiovascular toxicity,
including left ventricular depression,atrioventricular heart block,life threatnig
ventricular tachycardia, fibrillation and sudden cardiac arrest which is difficult to
resuscitate However levobupivacaine has similar efficacy but better safety profile than
racemic bupivacaine.


Dr Thatipamula Nagapraveen, Dr Vuppu Bhavani, Dr Neela Sandeep Kumar, Dr Pakala Swathi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5952-5961

Introduction:Postoperative analgesia after cesarean section poses unique clinical challenges
to anesthesiologist. Intrathecal buprenorphine is a promising drug for postoperative analgesia.
Aims: The aim of this study was to compare the efficacy of two doses of buprenorphine (45
μg and 60 μg) as an adjuvant to hyperbaric bupivacaine for postoperative analgesia in
caesarean section.
Materials and methods: This was a prospective, randomized, double-blind controlled study.
Ninety ASA physical status Class II parturients posted for elective caesarean section. The
computer-generated simple random sampling procedure was used to allocate the subjects into
three Groups A, B, C of 30 each.
Results: Addition of buprenorphine to intrathecal bupivacaine prolonged the duration and
quality of postoperative analgesia without producing any major side effect. The maximum
duration of analgesia and hence decreased analgesic requirement were obtained with 60 μg
buprenorphine. Addition of buprenorphine did not have any adverse outcome on the baby as
assessed by Apgar score.
Conclusion:Addition of buprenorphine to hyperbaric bupivacaine provides postoperative
analgesia after cesarean section without significant maternal and neonatal side effects.

Comparison of Hyperbaric Bupivacaine Alone and Combination of Hyperbaric Bupivacaine with Clonidine in Cesarean Section: A Prospective Randomized Clinical Trial

Aman Malawat, Sudhir Sachdev, Sakshi Kanoji, Mangilal Deganwa, Durga Jethava

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 10480-10489

Introduction: Spinal anaesthesia using hyperbaric bupivacaine with adjuvants such as
clonidine is now the routine and preferred technique for majority of the surgical cases.
Aim: to compare various block characteristics alongwith materno-fetal outcome in
patients scheduled for caesarean section under subarachnoid block (SAB), following
administration of hyperbaric bupivacaine alone and in combination with clonidine
Methods: In this randomized clinical trial, 90 patients undergoing elective cesarean
section were randomly allocated to two groups. The patients of Group A received
intrathecal 0.5% hyperbaric Bupivacaine (10 mg) + 0.2 mL of normal saline and Group
B received intrathecal 0.5% hyperbaric Bupivacaine (10 mg) + 0.2 mL of clonidine (30
μg). Various block characteristics and materno-fetal outcome were compared between
the groups.
Results: Group B had quicker sensory onset (3.17 ± 1.05 min vs. 3.50 ± 0.94 min), longer
duration of sensory and motor block (209.73 ± 30.70 min and 147.50 ± 23.00 min),
longer time for rescue analgesia demand (298.83 ± 44.68 min) in comparison to Group
Conclusion: Intrathecal clonidine provided better block characteristics and outcome
measures in terms of prolonged sensory as well as motor blockade, longer duration of
analgesia, greater intraoperative relaxation and minimal or no adverse incidences.