Comparison of the effect of epidural levobupivacaine 0.5% 20 ml and ropivacaine 0.75%, 20 ml in lower limb surgeries

Abstract

Introduction: Epidural blockade is becoming one of the most useful and versatile procedures in modern anesthesiology. It is unique in that it can be placed at virtually any level of the spine, allowing more flexibility in its application to clinical practice. It is more versatile than spinal anesthesia, giving the clinician the opportunity to provide anesthesia and analgesia, as well as enabling chronic pain management. It provides better postoperative pain control and more rapid recovery from surgery. Materials and methods: After obtaining informed written consent from patients, the study was conducted on 70 patients of either sex, between 18 and 65 years of age and belonging to the American Society of Anesthesiologists (ASA) Grade I and II physical status. Patients with the history of uncontrolled labile hypertension, heart block, dysrhythmia, on cardiac medication (adrenergic receptor antagonist, calcium channel blocker, or angiotensin converting enzyme inhibitor), addiction to narcotic, patient posted for lower segment cesarean section and with any contraindication to epidural anesthesia were not included in the study. Results: The objective of this study was to compare levobupivacaine 0.5% and ropivacaine 0.75% in epidural anesthesia in lower limb surgeries, with respect to onset and duration of motor blockade and sensory blockade, maximum dermatomal level of analgesia and time taken to achieve that. Group wise distribution of demographic data, like age, height, weight, body mass index (BMI), and sex were tabulated. On perusal of the same, we observe no significant deviation in any of these data among different groups of the cases. P value range was 0.067-0.982. Conclusion: It can be concluded that onset of sensory and motor block for levobupivacaine is delayed as compared with ropivacaine. Ropivacaine has shorter duration of motor block when compared with levobupivacaine. Thus, ropivacaine and levobupivacaine both can be used as an alternative to bupivacaine.