Spinal Anaesthesia Using Isobaric Levobupivacaine Alone and With Fentanyl for Lower Abdominal Surgery- A Randomised Double Blinded Controlled Trial

Verma, Devendra; Gehlot, Ravindra; Goda, Vineeta; Machhar, Meenakshi; Naithani, Udita; Didwania, Dinesh; Singh, Snigdha

doi:10.14260/jemds/2017/639

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…Verma et al (12) showed that adding fentanyl to intrathecal levobupivacaine in lower abdominal surgeries had effective sensory-motor blockade for a sufficient duration with stable hemodynamics. Narcotics have undesired effects such as vomiting and pruritis.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine Versus Clonidine as Additives for Spinal Anesthesia: A Comparative Study

Manoharan,

Paneer,

Elavarasan

et al. 2023

Anesth Pain Med

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Background: Postoperative pain management is vital to improve patient care. Successful postoperative pain relief is currently achieved only through NSAIDs and narcotics. Objectives: We compared Dexmedetomidine and Clonidine as additives to hyperbaric Levobupivicaine 0.5% for the sub-arachnoid block (spinal anesthesia) concerning the onset time, duration of the block, hemodynamic changes, level of sedation intraoperatively and postoperatively and time taken for the first postoperative analgesic request and frequency. Methods: This prospective, double-blind study enrolled 60 patients who underwent lower abdominal surgeries and were eligible for a sub-arachnoid block. They were allocated randomly to one of the two groups. Group D received intrathecal Dexmedetomidine 5 µg and 0.5% hyperbaric Levobupivicaine 15 mg. Group C received intrathecal Clonidine 50 µg and 0.5% hyperbaric Levobupivicaine 15 mg. Results: Patients who received Dexmedetomidine had a longer duration of the block (2-segment regression: 135 ± 15 min vs. 130 ± 20 min, S1 segment regression: 305 ± 50.4 min vs. 290 ± 47.2 min, Bromage 0: 285 ± 60 min vs. 280 ± 45 min), delayed first rescue analgesia request (700 ± 160 min vs. 506 ± 112 min), reduced frequency of rescue analgesics (1 vs. 2), and desired level of sedation (1.3 ± 0.46 vs. 0.4 ± 0.01) when compared to those receiving Clonidine. There were insignificant differences between the groups in intraoperative hemodynamic parameters, such as minimal bradycardia and minimal hypotension. Though Dexmedetomidine had an early onset, there was no statistically significant difference compared to Clonidine. Conclusions: Comparing Dexmedetomidine and Clonidine as additives in the sub-arachnoid block, the group who received Dexmedetomidine had similar onset, prolonged duration of blockade, delayed first rescue analgesia demand, reduced frequency of analgesics, and desired sedation with similar minimal hemodynamic changes such as bradycardia and hypotension.

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Section: Discussionmentioning

confidence: 99%

Dexmedetomidine Versus Clonidine as Additives for Spinal Anesthesia: A Comparative Study

Manoharan,

Paneer,

Elavarasan

et al. 2023

Anesth Pain Med

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“…15-20 mg isobaric 0.5% levobupivacaine is considered to be the intrathecal dosage. 18 Bupivacaine is a local anesthesia that is commonly used as spinal anesthetic due to its great efficacy and lack of neurotoxicity. Because of its equivalent potency and lower neurotoxic and cardiotoxic effects, levobupivacaine is becoming more popular as an alternative for bupivacaine.…”

Section: Discussionmentioning

confidence: 99%

Comparative evaluation of anesthetic efficacy and hemodynamic effects of intrathecal isobaric bupivacaine versus intrathecal isobaric levobupivacaine in the lower abdominal and lower limb surgeries

Sujatha¹,

Sundararajan²,

Asokan³

2022

Asian J Med Sci

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Background: The most frequently utilized approach in patients undergoing lower abdominal and lower limb procedures is spinal anesthesia with bupivacaine. Aims and Objectives: The aim of the study was to compare the anesthetic efficacy and hemodynamic effects of isobaric bupivacaine and isobaric levobupivacaine for spinal anesthesia. Materials and Methods: In our study, 80 patients (43 – male and 37 – female) between the ages of 18 and 70 years at Sri Venkateswaraa Medical College Hospital and Research Centre, Ariyur, Puducherry, were enrolled and split into Group I and Group II following approval by an ethical committee and written informed consent. Individuals in Group I were given 3 mL of preservative free 0.5% isobaric bupivacaine (Anawin™, bupivacaine hydrochloride, Neon laboratories, India), and Group II patients were given 3 mL of 0.5% isobaric levobupivacaine (Levoanawin™, levobupivacaine hydrochloride, Neon laboratories, India) for spinal anesthesia. A complete preanesthetic checkup was performed the day before surgery. Results: In this study, we observed no significant correlation between height, weight, and surgery duration. We discovered a statistically substantial distinction in motor and sensory blockade between the bupivacaine (Group I) and levobupivacaine (Group II) groups. In this study, Group I (50% of patients) had a lower occurrence of hypotension than Group II (20% of patients), indicating a statistically significant variation between the groups. Conclusion: When compared to levobupivacaine, individuals in the bupivacaine group required more administration of the vasoactive medicine ephedrine and the sympathomimetic drug atropine. Levobupivacaine is less cardiotoxic, neurotoxic, and equally potent local anesthetic compared to its racemate.

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Efficacy of intrathecal fentanyl versus buprenorphine as an adjuvant to isobaric levobupivacaine in lower limb surgeries: a comparative study

et al. 2021

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Spinal Anaesthesia Using Isobaric Levobupivacaine Alone and With Fentanyl for Lower Abdominal Surgery- A Randomised Double Blinded Controlled Trial

Cited by 3 publications

References 7 publications

Dexmedetomidine Versus Clonidine as Additives for Spinal Anesthesia: A Comparative Study

Dexmedetomidine Versus Clonidine as Additives for Spinal Anesthesia: A Comparative Study

Comparative evaluation of anesthetic efficacy and hemodynamic effects of intrathecal isobaric bupivacaine versus intrathecal isobaric levobupivacaine in the lower abdominal and lower limb surgeries

Efficacy of intrathecal fentanyl versus buprenorphine as an adjuvant to isobaric levobupivacaine in lower limb surgeries: a comparative study

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