A comparison of intrathecal levobupivacaine with hyperbaric bupivacaine for elective caesarean section: A prospective randomized study
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 10299-10307
AbstractIntroduction: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  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
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