Comparative evaluation of the clinical efficacy of 0.5% levobupivacaine and 0.5% racemic bupivacaine in epidural anaesthesia for elective varicose vein surgery

Background and Aim: Racemic bupivacaine is known to be the most cardio toxic among the amide local anaesthetic. In search of an alternative it was found that the levo enantiomer has a better safety profile. This purpose of this study is to compare the clinical efficacy of 0.5% levobupivacaine with 0.5% racemic bupivacaine in epidural anaesthesia. Materials and Methods: After the institutional ethical committee approval this double blind randomized prospective study was conducted on 50 male patients between January and August 2011. 25 patients were allocated to each group; group L received levobupivacaine and group R received racemic bupivacaine. Onset time, duration of block, level of sensory block and motor block were assessed and compared. Observation and Results: The mean onset time was 7.739±3.3033 and 8.04±3.048 minutes in group L and in group R respectively. Level of sensory block level noted was between T10 to T5, but most patients had the level at T6. The mean duration of residual analgesia was 412.56 ± 39.11 minutes in L group and 409.56 ± 44.46 minutes in R group. The onset time, duration of block, level of sensory block were comparable and were not statistically significant. But the motor block was found to be intense and was statistically significant in the patients in R group (p 0.0498) than in L group. Conclusion: In comparison to racemic bupivacaine, levobupivacaine produces a differential blockade but onset, duration, level of sensory blocks was similar. However racemic bupivacaine produces intense motor blockade when compared with levobupivacaine.