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

Neeraj; Niraj  Kumar; Sudama  Prasad; Rakesh  Kumar

doi:10.51168/sjhrafrica.v5i11.1813

Authors

Neeraj Senior Resident, Department of Anaesthesiology, Patna Medical College & Hospital, Patna, Bihar, India.
Niraj Kumar Senior Resident, Department of Anaesthesiology, Patna Medical College & Hospital, Patna, Bihar, India
Sudama Prasad Professor & HOD, Department of Anaesthesiology, Patna Medical College & Hospital, Patna, Bihar, India
Rakesh Kumar Assistant Professor, Department of Anesthesia & Critical Care, Patna Medical College & Hospital, Patna, Bihar, India

DOI:

https://doi.org/10.51168/sjhrafrica.v5i11.1813

Keywords:

Epidural anaesthesia, levobupivacaine, ropivacaine, lower limb surgery, sensory block, motor block, postoperative analgesia

Abstract

Background

Epidural anesthesia is extensively employed in lower limb procedures owing to its efficacy in sensory and motor blockage, as well as its capacity to deliver extended postoperative analgesia. Levobupivacaine and ropivacaine, both long-acting amide local anesthetics, exhibit advantageous safety profiles with decreased cardiotoxicity relative to bupivacaine.

Objective: The objective is to assess the clinical efficacy and safety of 0.5% levobupivacaine (20 mL) with 0.75% ropivacaine (20 mL) when delivered epidurally to adult patients having elective lower limb operations.

Methods

This prospective, randomized, double-blind trial was performed over a duration of 10 months at Patna Medical College & Hospital. Ninety patients classified as ASA grade I and II, scheduled for elective lower limb procedures, were randomly assigned to two groups (n=45 each):

Group L: Administered 20 mL of 0.5% levobupivacaine via epidural route

Group R: Administered 20 mL of 0.75% ropivacaine via epidural injection

The parameters monitored comprised the onset time and duration of sensory and motor blockade, the quality of surgical anesthesia, the length of postoperative analgesia, and the incidence of adverse events.

Results

The initiation of sensory and motor blockade occurred more rapidly in Group R than in Group L, with mean sensory onset periods of 9.2 ± 1.1 minutes and 11.3 ± 1.4 minutes, respectively. Group L demonstrated an extended duration of motor blockade and postoperative analgesia. Hemodynamic parameters remained steady in both cohorts, and no substantial detrimental effects were seen.

Conclusion

Both levobupivacaine 0.5% and ropivacaine 0.75% are efficacious for epidural anesthesia in lower extremity procedures. Ropivacaine facilitates a more rapid onset of anesthesia, whilst levobupivacaine delivers an extended duration of analgesia. The selection of the agent can be customized according to the length of the surgery and the intended postoperative analgesic outcome.

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