Shalini Patidar, Vatsala Aggarwal, Sourabh Khatri


BACKGROUND: Levobupivacaine, the pure S (−)-enantiomer of Bupivacaine, has strongly emerged as a safer alternative for regional anaesthesia than its racemic sibling, Bupivacaine. The intrathecal administration of a combination of opioids and local anaesthetics produces a well-documented synergistic effect without prolonged motor nerve block or delayed hospital discharge. Objective: Present study was conducted to compare the characteristics of spinal blocks produced by 0.5% levobupivacaine with and without fentanyl in lower abdominal and limb surgeries METHODS: The study was a hospital based randomized controlled double blinded study where 80 patients planned for lower abdominal and lower limb surgeries were randomly divided into two groups of 40 patients each. In Group-I (LF 40) 2.5 ml of total volume 0.5% isobaric Levobupivacaine 7.5mg(1.5ml) + fentanyl 25ugs(0.5ml) + 0.5ml normal saline and in Group-II (L 40) 0.5% Levobupivacaine 10mg (2ml) + normal saline (0.5 ml) was given. RESULTS: There were no significant differences between the two groups for patient demographic, intraoperative, hemodynamic parameters, side effects and satisfaction. The highest level of sensory block was T7 in the Group LF, and T9 in the Group L. Duration of motor block was shorter in Group LF than in Group L (162.75±15.02 min in Group LF; 185.25±11.54 min in Group L.  CONCLUSION: Combination of intrathecal fentanyl with low dose levobupivacaine provides good quality surgical anaesthesia with early motor recovery which could lead to early ambulation of the patient as a day case surgery.


Levobupivacaine, Fentanyl, Lower limb surgeries, motor block

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