Intraoperative epidural anesthesia and postoperative analgesia with levobupivacaine for major orthopedic surgery: a double-blind, randomized comparison of racemic bupivacaine and ropivacaine

Casati, Andrea; Santorsola, Roberta; Aldegheri, Giorgio; Fanelli, Guido; Berti, Marco; Fraschini, G.; Torri, G.

doi:10.1016/s0952-8180(02)00513-5

Cited by 81 publications

(66 citation statements)

References 17 publications

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“…13 Usage of equal doses of levobupivacaine and bupivacaine were reported in various studies and procedures to provide similar onset of sensory block (8-30 min), maximum cephalic spread (T7-T8) and duration of analgesia (4-6 h). 14,15 Author report the onset of motor block (Bromage scale 1) to be quicker in bupivacaine group than in levobupivacaine group. Kopacz DJ et al also reported the onset of motor block to be delayed with levobupivacaine.…”

Section: Discussionmentioning

confidence: 98%

“…time to start surgery; while others reported no difference between the two groups. [13][14][15] Author report the duration of postoperative analgesia in both bupivacaine and levobupivacaine group to be similar. Casati et al also reported that equipotent dosage of levobupivacaine and bupivacaine provide comparable post-operative pain relief and recovery of sensory and motor function.…”

Section: Discussionmentioning

confidence: 99%

“…Casati et al also reported that equipotent dosage of levobupivacaine and bupivacaine provide comparable post-operative pain relief and recovery of sensory and motor function. 15 The levobupivacaine and bupivacaine, when used in thoracic epidural anesthesia, provide comparable duration of post-operative analgesia after thoracic surgery. 19 It is also reported in the literature that addition of opioids (fentanyl, morphine) improves the quality and duration of post-operative analgesia.…”

Section: Discussionmentioning

confidence: 99%

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Bupivacaine 0.5% vs. levobupivacaine 0.5% for epidural anaesthesia for caesarean section: a comparative study

Pahuja

Tajne

Bhure

et al. 2018

Int J Basic Clin Pharmacol

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Background: Levobupivacaine has been purported to be as efficacious as Bupivacaine for epidural anaesthesia in recent literature.Methods: With the intent to study the same in caesarean section cases in our set up, we observed various intra- and post-operative variables in two groups (Levobupivacaine and Bupivacaine) of 60 healthy parturients. Sixty parturients for elective caesarean section were allocated randomly to receive epidural block with 10-20 ml of either 0.5% Levobupivacaine with Fentanyl 25µg or 0.5% Bupivacaine with Fentanyl 25µg to reach T6 level.Results: Mean total volume in Bupivacaine group was 15.23ml and in Levobupivacaine group was 12.76 ml. The difference was statistically significant. There was significant difference between the groups in the sensory block. The onset of analgesia was earlier in Levobupivacaine group. Mean time was 6.20 minutes in Bupivacaine group and 4.36 minutes in Levobupivacaine group. The duration of motor block was significantly short in Levobupivacaine group. Mean Time for recovery from motor block in Bupivacaine group was 2.5 hours and in Levobupivacaine group 1.5 hours. Mean time to achieve T6 height was earlier in Levobupivacaine group i.e. 16.46 minutes in Bupivacaine group and 13.26 minutes in Levobupivacaine group. Duration of postoperative analgesia was similar. There was no significant difference in neonatal outcome.Conclusions: Levobupivacaine was found to fare better than Bupivacaine in the studied intra and post-operative parameters and is hence recommended over racemic Bupivacaine for epidural block in patients undergoing elective cesarean section.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Bupivacaine 0.5% vs. levobupivacaine 0.5% for epidural anaesthesia for caesarean section: a comparative study

Pahuja

Tajne

Bhure

et al. 2018

Int J Basic Clin Pharmacol

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“…7 This is also evidenced by other studies; comparable results were found by many studies using low concentrations of Levobupivacaine and high concentrations of Ropivacaine. Peduto et al, 8 (epidural levobupivacaine 0.5% vs epidural ropivacaine 0.75%), Casati et al, 9 (PCEA levobupivacaine 0.125% vs PCEA ropivacaine 0.2%), Rao et al, 10 (epidural levobupivacaine 0.5% vs epidural ropivacaine 0.75%).…”

Section: Discussionmentioning

confidence: 99%

“…16 However, the median duration of analgesia when 0.5% Ropivacaine was injected for surgery was 1.7-4.2 hours. 22 This can be further substantiated by studies conducted by Peduto et al 8 Kara et al 21 Senard et al 23 Rao et al 10 Brown et al 24 Morrison et al 18 where the duration of analgesia produced by Ropivacaine is much lesser in comparison to Levobupivacaine.…”

Section: Postoperative Analgesiamentioning

confidence: 91%

A clinical comparative study of 0.2% levobupivacaine with 25 mcg fentanyl versus 0.2% ropivacaine with 25 mcg fentanyl for post-operative epidural analgesia in patients undergoing lower limb orthopaedic surgeries

Boregowda¹,

Linganna²,

Raju³

2020

IJCA

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A clinical comparative study of 0.2% levobupivacaine with 25 mcg fentanyl versus 0.2% ropivacaine with 25 mcg fentanyl for post-operative epidural analgesia in patients undergoing lower limb orthopaedic surgeries Abstract Objectives: The objectives of our study were to compare the efficacy and safety of 0.2% Levobupivacaine with 25 mcg Fentanyl and 0.2% Ropivacaine with 25 mcg Fentanyl given epidurally for post-operative analgesia in patients who were operated electively for lower limb orthopaedic conditions under spinal anaesthesia. Materials and Methods:Sixty patients belonging to American Society of Anaesthesiologists (ASA) Class I and II of both sexes, of age within 20 -60 years were included in the study after obtaining institutional ethical committee clearance. Patients were divided randomly into 2 groups: Group -LF which received 8 ml of 0.2% Levobupivacaine with 25 mcg Fentanyl and Group -RF which received 8 ml of 0.2% Ropivacaine with 25 mcg Fentanyl. Surgery was conducted under spinal anaesthesia. Later 8 ml of the test drug combination was given epidurally in the post-operative period when the patient complained of pain (VAS score > 4) and the parameters were recorded periodically until pain reappeared (VAS score > 4). Results:In both the groups mean duration of surgery, changes in haemodynamics and demographic profiles were comparable. However the total duration of post-operative analgesia in Levobupivacaine group was 325 +/-63.06 minutes and in Ropivacaine group was 210 +/-24.91 minutes respectively and this appeared to be statistically significant. Conclusion: Compared to 0.2% Ropivacine with 25 mcg Fentanyl, 0.2% Levobupivacaine with 25 mcg Fentanyl provides intense and longer duration of post-operative analgesia with similar haemodynamic stability.

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Local and Regional Anesthesia in the Elderly

Gragasin

Tsui

2017

Complications of Regional Anesthesia

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Intraoperative epidural anesthesia and postoperative analgesia with levobupivacaine for major orthopedic surgery: a double-blind, randomized comparison of racemic bupivacaine and ropivacaine

Cited by 81 publications

References 17 publications

Bupivacaine 0.5% vs. levobupivacaine 0.5% for epidural anaesthesia for caesarean section: a comparative study

Bupivacaine 0.5% vs. levobupivacaine 0.5% for epidural anaesthesia for caesarean section: a comparative study

A clinical comparative study of 0.2% levobupivacaine with 25 mcg fentanyl versus 0.2% ropivacaine with 25 mcg fentanyl for post-operative epidural analgesia in patients undergoing lower limb orthopaedic surgeries

Local and Regional Anesthesia in the Elderly

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