A Randomised Prospective Study For Clinical Comparison Of 0.5 % Hyperbaric Bupivacaine Vs 0.5% Hyperbaric Levobupivacaine For Patients Undergoing Cesarean Section Under Spinal Anesthesia
DOI:
https://doi.org/10.64252/x6ardr55Keywords:
Subarachnoid block, Hemodynamic stability, Motor blockade, Sensory blockade.Abstract
Background: Subarachnoid block (spinal anesthesia) is a commonly used anesthetic technique for lower abdominal surgeries including abdominal hysterectomy. Bupivacaine 0.5% hyperbaric solution is a standard drug used due to its profound sensory and motor blockade. However, its R(+) isomer has been associated with cardiotoxicity. Levobupivacaine, the pure S(-) enantiomer of bupivacaine, offers similar anesthetic effects with improved safety and a reduced risk of cardiovascular and central nervous system toxicity.
Aim: To clinically compare 0.5% hyperbaric bupivacaine and 0.5% hyperbaric levobupivacaine in patients undergoing abdominal hysterectomy under spinal anesthesia, focusing on anesthetic efficacy, hemodynamic stability, and side effect profile.
Methods: This prospective, randomized, double-blind clinical study involved 120 female patients aged 30–60 years, ASA physical status I and II, undergoing elective abdominal hysterectomy. Patients were randomly allocated into two equal groups. Group B received 3.5 mL of 0.5% hyperbaric bupivacaine (17.5 mg), and Group L received 3.5 mL of 0.5% hyperbaric levobupivacaine (17.5 mg) intrathecally. Sensory and motor block onset, duration, regression, hemodynamic changes, and adverse events were monitored.
Results: Both groups achieved effective sensory and motor block suitable for surgery. Levobupivacaine exhibited better hemodynamic stability with a lower incidence of hypotension and bradycardia. It also showed faster motor recovery with minimal side effects.
Conclusion: 0.5% hyperbaric levobupivacaine is a clinically effective and safer alternative to 0.5% hyperbaric bupivacaine for spinal anesthesia in abdominal hysterectomy. It offers comparable anesthetic efficacy with improved cardiovascular safety and shorter motor blockade duration, making it a favorable option for regional anesthesia.
