A PROSPECTIVE RANDOMIZED STUDY FOR COMPARISON OF 0.5% LEVOBUPIVACAINE AND 0.5% BUPIVACAINE WITH FENTANYL FOR EPIDURAL ANAESTHESIA IN PATIENTS UNDERGOING HYSTERECTOMY

Introduction: Epidural anaesthesia is one of the best accepted and most versatile procedure in modern anaesthesiology for lower abdominal surgeries as it provides good sensory and motor block with contracted bowels, retaining spontaneous respiration, haemodynamic stability, and also an indwelling catheter which facilitates further administration of analgesic drugs for the postoperative period. Aim: This study was aimed to compare racemic bupivacaine and levobupivacaine in epidural anaesthesia for hysterectomies using fentanyl as common adjuvant. Material and Methods: A randomised prospective study was conducted on sixty patients of age group between 18-60 years of age with ASA grade 1 and 2 undergoing hysterectomy under epidural anaesthesia. Patients were randomly divided into two groups , Group A [n=30] received 0.5% levobupivacaine [15-20ml] with fentanyl[75 mcg] and Group B received 0.5% bupivacaine[15-20ml] with fentanyl [75mcg]. In both groups's onset of sensory and motor block. duration of analgesia, level of sedation ,haemodynamic parameters and complications were assessed perioperatively. Results: Mean duration of onset of sensory block in group A was 6.42 and 6.18 mins in group A and B respectively and mean duration of onset of motor block was 16.62 and 16.40 min in group A and B respectively, which were comparable for both groups as p value was >0.05. The mean duration of analgesia in group A was 5.33 hrs and in group B was 5.45 hrs, which was comparable in both groups with p value of 0.300 [>0.05].Haemodynamic parameters and complications were statistically non significant in both groups [>0.05]. Conclusion: combination of levobupivacine and fentanyl is equipotent to bupivacaine and fentanyl in epidural anaesthesia for hysterectomies as both provided stable haemodynamics with adequate sensory and motor anaesthesia devoid of any significant adverse effects.