Levobupivacaine and Bupivacaine in Spinal Anesthesia for Transurethral Endoscopic Surgery
Opas Vanna MD*, Lamai Chumsang BSc**, Sarinra Thongmee BSc, MEd**
Affiliation : * Department of Anesthesiology, Sappasitthiprasong Hospital, Ubon Ratchatani ** Nurse Anesthetist, Department of Anesthesiology, Sappasitthiprasong Hospital, Ubon Ratchatani
Background and
Objectives : Bupivacaine is available as a racemic mixture of dextrobupivacaine and
levobupivacaine. Many studies show that dextrobupivacaine has a greater inherent central nervous system
and cardiovascular toxicity than levobupivacaine. The objective of the present study was to investigate the
clinical efficacy and safety of isobaric solution of levobupivacaine compared with hyperbaric solution of
racemic bupivacaine in spinal anesthesia.
Materials and Methods : The authors studied 70 patients undergoing elective transurethral endoscopic surgery
who received either0.5% isobaric levobupivacaine (n = 35) or 0.5% hyperbaric bupivacaine (n = 35)
intrathecally, in a randomized, double blind study.
Results : The two groups were similar in terms of time to block suitable for surgery, duration of sensory block,
time to two segments regression, time to T12 regression, time to onset and offset of motor block, verbal numeric
pain scores at the start of the operation and adverse events.
Conclusion : The present study indicated that 2.5 ml of 0.5% isobaric levobupivacaine and 0.5% hyperbaric
of racemic bupivacaine show equally effective potencies for spinal anesthesia, regard to both the onset time
and duration of sensory blockade.
Keywords : Regional anesthesia, Intrathecal, Spinal anesthesia, Local anesthetics, Urologic, Endoscopic, Transurethral
