Comparison of two concentrations of isobaric intrathecal levobupivacaine for vaginal hysterectomy

Chattopadhyay, Shibram; Halder, Bibhas; Saha, Gobindo Chandra; Karmakar, Sukla; Pahari, Subrata

doi:10.4103/0970-5333.124600

Cited by 7 publications

(6 citation statements)

References 14 publications

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“…[ 13 ] Chattopadhyay et al . [ 19 ] concluded that addition of fentanyl to levobupivacaine does not increase the incidence of bradycardia. Akan et al .…”

Section: Discussionmentioning

confidence: 99%

Comparison of levobupivacaine and levobupivacaine with fentanyl in infraumbilical surgeries under spinal anaesthesia

Attri

Kaur

et al. 2015

Anesth Essays Res

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Background:Intrathecal opioids added to low dose local anesthetics in spinal anaesthesia intensifies sensory block without affecting sympathetic blockade. Aim was to evaluate the safety and efficacy of intrathecal levobupivacaine plain versus levobupivacaine plus fentanyl in infraumbilical surgeries.Materials and Methods:In a prospective randomized double blind study, 100 patients of American Society of Anesthesiologists grades I and II of either sex, 20–65 years of age were included after approval from the Ethics Committee. Informed consent was taken and patients were randomly divided into two groups of 50 each, to receive either 2 ml of 0.5% isobaric levobupivacaine (group L) or 2 ml of 0.5% isobaric levobupivacaine + 25 μg fentanyl (group LF) intrathecally. Patients were monitored for sensory and motor block characteristics, postoperative analgesia, haemodynamics and side effects and complications for 24 h.Results:Onset of sensory block and time to maximum sensory block was rapid in group LF (4.8 ± 1.50 and 8.46 ± 1.87 min) as compared to group L (7.6 ± 1.46 and 15.80 ± 2.43 min) (P < 0.000). Maximum sensory block was T6 in group LF and T8 in group L. Maximum Bromage score was 2 in both groups but was achieved earlier in group LF (P < 0.000). Duration of sensory and motor block was significantly prolonged in group LF (270.98 ± 28.60 and 188.52 ± 9.81 min) as compared to group L (197.58 ± 11.20 and 152.76 ± 9.79 min). Total duration of analgesia was also prolonged in group LF (265.16 ± 26.18 min) as compared to group L (168.16 ± 11.08 min). Patients remained haemodynamically stable and side effects and complications were comparable in both groups. Data was analyzed using “Chi-square test” and “unpaired t-test.”Conclusion:Addition of fentanyl to levobupivacaine leads to early onset and prolonged duration of sensory and motor block as well as postoperative analgesia with stable haemodynamics and minimal side effects.

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“…[ 13 ] Chattopadhyay et al . [ 19 ] concluded that addition of fentanyl to levobupivacaine does not increase the incidence of bradycardia. Akan et al .…”

Section: Discussionmentioning

confidence: 99%

Comparison of levobupivacaine and levobupivacaine with fentanyl in infraumbilical surgeries under spinal anaesthesia

Attri

Kaur

et al. 2015

Anesth Essays Res

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“…Similarly Chattopadhyay et al concluded that addition of fentanyl to levobupivacaine does not increase the incidence of bradycardia. [9,10] Lee et al also further reported no significant difference in study groups in the hemodynamic changes, and the quality of sensory and motor block when 2.6ml of 0.5% levobupivacaine was compared with 2.3ml of 0.5% levobupivacaine with fentanyl 15µgm. [5] Owing to the lower affinity of the S (-) isomer to cardiac sodium channels compared to the R isomer, levobupivacaine is associated with less cardiac side effects.…”

Section: Discussionmentioning

confidence: 95%

Comparative Evaluation of Clinical Efficacy of Adding Adjuvant to Intrathecal Levobupivacaine or Bupivacaine in Patients Undergoing Surgeries Under Spinal Anaesthesia

Jain¹,

Navjeet²,

Mukherjee³

2018

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Background: Levobupivacaine has been claimed to have safer cardiovascular profile. However, single injection intrathecally produces limited duration of surgical anaesthesia. Hence we comparatively evaluated the effects of adding fentanyl to levobuivacaine and bupivacaine on spinal anaesthesia characteristics. Methods: 50 American Society of Anaesthesiologists grade I-II patients undergoing lower abdominal and lower limb surgeries were divided into two groups of 25 patients each. Intrathecally, 20µgm fentanyl was given with 2.6 ml of levobupivacaine (group L) or bupivacaine (Group B). Results: There was no significant difference between the two groups on time of onset and time taken to reach the maximum sensory block level. There was also no significant difference on the maximum levels of sensory block attained between the two groups. The duration of sensory regression to S1 was 262.80±20.13 minutes in group L, while it was 272.40±19.43 minutes in group B (p=0.09). Rescue analgesia was given at 219.80±24.26 minutes in group L, and at 230.00±19.58 minutes in group B (p=0.1). The duration of motor block was 215.60±22.56 minutes in group L, and 217.24±27.04 minutes in group B (p=0.82). Conclusion: Our study demonstrated no significant difference existed on time of onset and time taken to reach the maximum sensory block level when fentanyl was added to intrathecal isobaric levobupivacaine or bupivacaine. No significant difference existed on the maximum levels of sensory block attained between the two groups, as well as on the duration of sensory and motor blocks.

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“…compared the anesthetic efficacy and safety of two concentrations of local anesthetic agent levobupivacaine in patients undergoing vaginal hysterectomy. [ 15 ] Forty-four patients of ASA physical status Classes I and II were randomized to receive an intrathecal injection of one of two local anesthetic solutions. Each patient in Group A ( n = 22) received 2 ml of isobaric levobupivacaine 5 mg/ml (10 mg) with 25 μg of fentanyl, while each patient in Group B ( n = 22) received 4 ml of isobaric levobupivacaine 2.5 mg/ml (10 mg) with 25 μg of fentanyl, onset of sensory block till T10 for Group A (2 ml isobaric levobupivacaine 5 mg/ml with 25 μg of fentanyl) was 6.9 ± 1.7 min and for Group B (4 ml isobaric levobupivacaine 2.5 mg/ml with 25 μg of fentanyl) was 6.4 ± 1.5 min ( P > 0.05).…”

Section: Discussionmentioning

confidence: 99%

“…in which they found a faster onset of sensory blockage of 6.9 ± 1.7 min when fentanyl 25 μg was used as an adjuvant to 3 ml 0.5% isobaric levobupivacaine. [ 15 ]…”

Section: Discussionmentioning

confidence: 99%

Evaluating the efficacy of tramadol as an adjuvant to intrathecal isobaric levobupivacaine for elective infraumbilical surgeries

et al. 2017

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Background:Long-acting local anesthetics are used in subarachnoid block to increase the duration of anesthesia. Adjuvants are added to improve the duration of analgesia.Settings:Randomized controlled trial was conducted in the Department of Anesthesiology in a tertiary care hospital.Aims and Objectives:The objective of this study was to evaluate the efficacy of low-dose tramadol as an intrathecal adjuvant to levobupivacaine in terms of duration of analgesia, onset of sensory blockade, onset of motor blockade, and duration of motor blockade.Methodology:After obtaining the Institutional Ethics Committee approval and informed consent, sixty patients posted for infraumbilical surgeries were recruited. Randomization was done using a sealed envelope technique. Patients were divided into two groups: LT received 3 ml of 0.5% isobaric levobupivacaine with tramadol 10 mg (0.2 ml) and LS received 3 ml of 0.5% isobaric levobupivacaine with 0.2 ml of normal saline. Duration of analgesia, onset of sensory blockade, and onset and duration of motor blockade were recorded.Results:There was no statistical difference in demographic data between the two groups. The mean onset time of sensory blockade in Group LS was 12.7 ± 9.81 min and for Group LT was 12.9 ± 0.81 min, which was not statistically significant between two groups (P = 0.93). The mean onset time of motor blockade in Group LS was 13.4 ± 10 min and for Group LT was 14.4 ± 10 min, which was no statistically significant between the two groups (P = 0.71). The mean time duration of analgesia in Group LS was 170.3 ± 59 min and for LT was 198.9 ± 57.33 min. There was mild prolongation of analgesia in Group LT, but it was not statistically significant (P = 0.0615). The mean duration of motor blockade in Group LS was 170.23 ± 58 min and Group LT was 190.76 ± 4 min, which was not statistically significant between the two groups (P = 0.14).Conclusion:Low-dose tramadol as an adjuvant to isobaric intrathecal levobupivacaine does not prolong analgesia significantly.

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Comparison of two concentrations of isobaric intrathecal levobupivacaine for vaginal hysterectomy

Cited by 7 publications

References 14 publications

Comparison of levobupivacaine and levobupivacaine with fentanyl in infraumbilical surgeries under spinal anaesthesia

Comparison of levobupivacaine and levobupivacaine with fentanyl in infraumbilical surgeries under spinal anaesthesia

Comparative Evaluation of Clinical Efficacy of Adding Adjuvant to Intrathecal Levobupivacaine or Bupivacaine in Patients Undergoing Surgeries Under Spinal Anaesthesia

Evaluating the efficacy of tramadol as an adjuvant to intrathecal isobaric levobupivacaine for elective infraumbilical surgeries

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