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Abstract

EFFECT OF INTRATHECAL LEVOBUPIVACAINE AND BUPIVACAINE WITH FENTANYL ON POSTOPERATIVE AMBULATION AND ANALGESIA: A RANDOMIZED CONTROLLED TRIAL.

*Rishi Kumar Gautam, Rajesh Singh Rautela, Mahendra Kumar and Chhavi Sharma

ABSTRACT

Background: This study was conducted with the aim to compare Levobupivacaine and Bupivacaine in terms of ambulation and analgesic efficacy given by intrathecal route in patients undergoing lower abdominal surgery. Methods: Seventy patients belonging to ASA PS I & II were included undergoing lower abdominal surgery under subarachnoid block. They were randomly assigned to receive one of the following isobaric Levobupivacaine 10 mg or Bupivacaine 10 mg all combined with Fentanyl 25 μg. Surgery was allowed once the sensory blockade reached T10 level. Sensory changes and motor changes along with hemodynamic parameters were recorded. Time for successful ambulation was also noted. Results: Walk of 5 meters in a straight line was taken as the time for ambulation which was shorter in Levobupivacaine group with mean of 437.14±33.56 min collated with the mean of 460.29±21.75 min in group Bupivacaine which was statistically significant (p<0.05). Hence Levobupivacaine group patients ambulated earlier than bupivacaine. The duration of effective analgesia in Levobupivacaine group was clinically significant with mean of 360.86±42.10 min, hence favouring pain free early ambulation with minimal hemodynamic effects compared to Bupivacaine. Conclusions: S(-) enantiomer Levobupivacaine has materialized to be a rousing intrathecal local anesthetic agent for day care surgeries.

Keywords: local anesthetics, intrathecal, lower abdominal surgery, subarachnoid, regional techniques.


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