Med J Malaysia. 2025 Dec;80(Suppl 8):1-5.
ABSTRACT
INTRODUCTION: Our study focuses on comparing the motor and haemodynamic effects of levobupivacaine 0.5% and ropivacaine 0.75% when administered as epidural anaesthesia for surgeries below the umbilicus. This comparison is particularly important given that the racemic mixture of bupivacaine, which includes the dextro (D-(+)) and levo (L-(-)) isomers in equal proportion, is associated with significant cardiovascular and central nervous system complications, particularly due to the R-(+)-isomer. In contrast, the levorotatory isomers like our study drug levobupivacaine and ropivacaine are noted for their more reliable and stable pharmacological profiles.
MATERIALS AND METHODS: Fifty-six patients with the American Society of Anaesthesiologists (ASA) classification 1 and 2 classifications were randomly assigned to one of two study groups.(17 ml of 0.5% levobupivacaine was given epidurally in Group L, while Group R received 17 ml of 0.75% ropivacaine).The prospective randomised double blinded study was carried out at Saveetha Medical College Hospital, S.I.M.A.T.S., from 2022 to 2024.
RESULTS: The duration, onset, and regression of motor block were comparable in both groups. The motor block grade as per MBS in the two groups showed significant differences. (p<0.001) Group R achieved maximum motor blockage in 40.18 minutes, whereas group L achieved it in 17.86 minutes (p=0.043). In group R, the average duration of motor block was 146.25±48.58 minutes, while in group L it was 160.71±46.64 minutes (p>0.05). Heart rate (HR), mean arterial pressure (MAP), and oxygen saturation (SpO2) exhibited no significant differences between the two groups at various time intervals.
DISCUSSION: Both levobupivacaine 0.5% and ropivacaine 0.75% effectively provide epidural anaesthesia for surgeries below the umbilicus. Levobupivacaine achieved maximum motor block more quickly than ropivacaine, but overall motor block duration was similar. Haemodynamic parameters were stable with no significant differences between the two groups.
PMID:41456135