Comparison of Onset and Duration of Sensory and Motor Blockade with Intrathecal Isobaric Bupivacaine versus Isobaric Levobupivacaine for Infraumbilical Surgeries- A One Year Hospital Based Double- Blind Randomised Controlled Trial

Abstract

Background and Objective Spinal anaesthesia is a well known technique used in lower abdominal surgeries. Spinal anaesthesia is routinely performed with racemic 0.5% bupivacaine in the present anaesthesia practice. Levobupivacaine is a pure S enantiomer of bupivacaine and hence has less cardiac and central nervous system toxicity compared to bupivacaine. We attempted to compare onset and duration of sensory and motor blockade with intrathecal isobaric bupivacaine and levobupivacaine in patients posted for elective infraumbilical surgeries. Methods This one year double blind randomized controlled trial was conducted in the Department of Anaesthesiology, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum, during the period of June 2013 to June 2014. A total of 70 ASA I and II patients posted for elective infraumbilical were allocated into 2 groups. Group B received intrathecal 3 ml of 0.5 % isobaric bupivacaine and Group L received intrathecal 3 ml of 0.5% isobaric levobupivacaine. Onset and duration of sensory and motor blockage were compared between the two groups. Results In this study, both the groups were comparable with respect to sex, age and height. It was found that two groups were comparable in terms of onset for sensory block (5.2 ± 0.63 minutes versus 5.3 ± 0.66 minutes with p = 0.583); duration of sensory block (169.4 ± 13.04 minutes versus 170.6 ± 16.83 minutes with p=0.691); onset for motor block (10.8±0.91 minutes versus 10.9±0.74 minutes with p=0.474); duration of motor (286.6 ± 13.92 minutes versus 284 ± 10.34 minutes with p=0.384). There was no statistical difference between the two groups. The two groups showed no difference in terms of hemodynamic parameters measured. Conclusion and interpretation Levobupivacaine is less cardio and cerebral toxic than bupivacaine. And from the above study we may conclude that intrathecal levobupivacaine is comparable to bupivacaine in terms of onset and duration of sensory and motor blockade. There is no significant hemodynamic variation between them.