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A randomised double-blind comparison of spinal levobupivac ane 0.5 percent versus bupivacaine 0.5 percent.


Mara Ang-Cabrera,
Jonnell L. Lim,
Maela Joyce Andres-Lim

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Publication Information

Publication Type
Publication Sub Type
Journal Article, Original
St. Luke's Medical Journal
Publication Date
July-December 2005


Introduction. Levobupivacaine is the pure S(-)-enantiomer of racemic bupivacaine but is less toxic to the heart and central nervous system. Although it is currently being used for obstetric and non-obstetric epidural anesthesia, there are few comparative clinical studies on its intrathecal administration. We therefore performed this prospective, randomized double-blinded study to compare the clinical efficacies of intrathecal levobupivacaine versus racemic bupivacaine.

Methods. Twenty patients undergoing elective minor surgery received either 3ml levobupivacaine 0.5 percent isobaric or 3ml bupivacaine 0.5 percent isobaric. Sensory blockade and motor blockade were documented. Hemodynamic variables were also recorded as well as adverse reactions to either drug.

Results. The study showed that intergroup differences between levobupivacaine and bupivacaine were insignificant both with regard to the onset of sensory blockade as well as the duration of sensory and motor blockade. However, there was a significant delay in the onset of motor blockade with the levobupivacaine group (21 +/- 14 versus 10 +/- 7). Both groups showed slight reductions in heart rate and mean arterial pressure, but there was no intergroup difference in hemodynamics.

Conclusion. We conclude that intrathecal levobupivacaine is comparable to racemic bupivacaine in terms of sensory onset and sensory/motor duration with a significant delay in motor onset.


The objective of our study is to compare the clinical efficacy of Levobupivacaine and Bupivacaine for spinal anesthesia. Parameters to be monitored include the onset and duration of sensory and motor block, hemodynamics and the occurrence of adverse events, if any.

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