A comparison of efficacy and tolerablity of epidural Levobupivacaine 0.5% with 0.5% Racemic mixture Bupivacaine for lower abdominal surgery

Abstract

This study was performed to compare the efficacy and tolerability of 0.5% racemic Bupivacaine and 0.5% Levobupivacaine, in patients undergoing lower abdominal surgery. 56 patients, ASA grade 1 and 2, were randomized to receive an epidural injection of study drug (17 ml 0.5% racemic Bupivacaine in group R and 17 ml of 0.5% Levobupivacaine in group L). The time to onset of adequate sensory block (T10 dermatome), maximum dermatome reached, time taken to reach maximum dermatome, time for 2 segment regression, time taken to regress to T10 were comparable. Although the onset of motor block was comparable in both the groups, Group L showed earlier commencement of motor block at 5 min after zero time. (P value 0.002). The regression of motor block was faster in group L (p value 0.042). The time to obtain maximum level of motor blockade was found to be faster in L group. (p value of 0.043). The number of patient obtaining MBS score of 3 was 62.5% in R group and 37.5% in L group. The grade of motor block showed that, the L group had lesser grade than that of Racemic group (p value of 0.016). The duration of motor block was similar in both the groups. The need for rescue analgesics, total IV fluid requirement and ephedrine usage, MAP,HR and the time of request for post-operative analgesia were similar. Both local anaesthetics were well tolerated and effective in producing epidural anaesthesia for patients undergoing lower abdominal surgery.