Dr. Sanjay kumar morwal, Dr. Trishala jain


This study was done to  compare the anesthetic efficacy and safety of three local anesthetic agents : racemic bupivacaine and its two isomers : ropivacaine and levobupivacaine, in patients undergoing transurethral resection of prostate. One hundred-sixty two patients, ASA I-III, were randomized to receive an intrathecal injection of one of three local anesthetic solutions. Group B (n = 54) received 2 ml of isobaric bupivacaine 5 mg/ml(10 mg). Group R (n = 54) received 2 ml of isobaric ropivacaine 5 mg/ml (10 mg). Group L (n = 54) received 2 ml of isobaric levobupivacaine 5 mg/ml (10 mg). The onset and duration of sensory block at dermatome level T10,time to achieve highest level of sensory block,  regression of sensory block up to L-1 as well as the onset,

and duration of motor block were recorded, as were any adverse effects, such as bradycardia , hypotension, hypoxia, tremor, nausea and/or vomiting.The onset of motor block was significantly faster in the bupivacaine group compared with that in the ropivacaine group and almost the same of that in the levobupivacaine group (P < 0.05). Ropivacaine presented a shorter duration of both motor and sensory block than bupivacaine and levobupivacaine (P < 0.05).

Bupivacaine required more often the use of a vasoactive drug (ephedrine) compared to both ropivacaine and levobupivacaine and of a sympathomimetic drug (atropine) compared to the ropivacaine group.


Anesthetic techniques, regional ; anesthetic techniques, subarachnoid ; anesthetics local, bupivacaine ; ropivacaine ; levobupivacaine ; surgery.

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