A COMPARATIVE CLINICAL STUDY OF ANAESTHESIA WITH ISOBARIC LEVOBUPIVACAINES IN CASES UNDERGOING LOWER LIMB SURGERIES UNDER SPINAL ANESTHESIA OR PERIPHERAL NERVE BLOCKS .

Prem Shanker Malviya, Dharmendra Kumar Yadav, Amar Singh Chandrawal

Abstract


 Levobupivacaine is  long acting local anaesthetic drug introduced in  practice. The study has been made  to compare the anaesthesia produced by this drug used in  two different techniques - subarachnoid block or peripheral nerve blocks . Methodology -  A prospective, comparative, randomised , double blind clinical study was carried in S.R.N. hospital , Allahabad (Prayagraj) over a period of two years  after approval  from ethical committee of the institution . Sixty patients belonging to physical ASA 1 or 2 having cardiovascular or respiratory diseases (well controlled with medication ) , aged 18-60 years undergoing lower limb surgeries were included . Two groups A and B of thirty  each were made .Group A received 3ml isobaric Levobupivacaine 0.5% in subarachnoid block , Group B received combined sciatic-femoral nerve blocks ( along with Obturator and Lateral Cutaneous nerve of thigh block when required) given with same drug . Observations for onset, quality, duration of sensory and motor blocks ; pulse , BP , electro cardiography and SpO2  were made. Rapid onset of sensory and motor blocks was observed in patients given spinal (p < 0.05). Postoperative analgesia was longer in patients given nerve block (p < 0.05) . Quality of anaesthesia in both groups was good. There was fall in blood pressure  at 1  and 4 hour in few cases in spinal group (p < 0.05). Both groups showed stable vital parameters .Conclusion - Anaesthesia was good , safe and comparable with both techniques. Post operative analgesia was additional advantage with nerve blocks which added to patient’s satisfaction  . Future work – The study can be further extended to patients havings co morbidities where safety of anaesthesia is a concern.


Keywords


isobaric Levobupivacaine , subarachnoid block , peripheral nerve blocks .

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References


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