A prospective, randomized, double-blind comparison of epidural levobupivacaine 0.5% with epidural ropivacaine 0.75% for lower limb procedures

Eur J Anaesthesiol. 2003 Dec;20(12):979-83. doi: 10.1017/s0265021503001583.

Abstract

Background and objective: This prospective, randomized, observer-blinded study compared onset time and duration of epidural anaesthesia produced by with levobupivacaine and ropivacaine for lower limb surgery.

Methods: ASA I-III adult patients undergoing elective lower limb procedures were randomized to receive epidural levobupivacaine 0.5% 15 mL (n = 30) or epidural ropivacaine 0.75% 15 mL (n = 35). A blinded observer evaluated onset time and regression of motor and sensory block, and intraoperative needs for fentanyl supplementation (0.1 mg intravenously).

Results: With levobupivacaine, onset time was 29 +/- 24 min, with ropivacaine it was 25 +/- 22 min (P = 0.41). Complete resolution of motor block required 105 +/- 63 min with levobupivacaine and 95 +/- 48 min with ropivacaine (P = 0.86). The time for regression of sensory block to T12 was 185 +/- 77 min with levobupivacaine and 201 +/- 75 min with ropivacaine (P = 0.46). Analgesic supplementation was required in one patient receiving levobupivacaine (3.5%) and in two patients receiving ropivacaine (5.7%) (P = 0.99).

Conclusions: In adults undergoing lower limb surgery, levobupivacaine 0.5% 15 mL produces an epidural block with the same clinical profile as ropivacaine 0.75% 15 mL.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Amides / administration & dosage
  • Amides / therapeutic use*
  • Analysis of Variance
  • Anesthesia, Epidural / methods*
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / therapeutic use
  • Bupivacaine / administration & dosage
  • Bupivacaine / analogs & derivatives
  • Bupivacaine / therapeutic use*
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Humans
  • Levobupivacaine
  • Lower Extremity / surgery*
  • Male
  • Movement / drug effects
  • Pain / prevention & control*
  • Prospective Studies
  • Ropivacaine
  • Sensation / drug effects
  • Time Factors
  • Treatment Outcome

Substances

  • Amides
  • Anesthetics, Local
  • Ropivacaine
  • Levobupivacaine
  • Bupivacaine