Comparison of Isobaric Levobupivacaine 0.5% with Isobaric Ropivacaine 0.5% in Spinal Anaesthesia in Lower Limb Surgeries in Adult Patients

Background: Ropivacaine and Levobupivacaine are amide local anesthetics with better safety profile as compared to Bupivacaine. This study was performed to compare the anesthetic efficacy and safety of two local anesthetic agents, Isobaric 0.5% Ropivacaine and Isobaric 0.5% Levobupivacaine, in patients undergoing elective lower limb surgeries under spinal anesthesia, using 3ml (15mg) of each. Materials and Methods: 60 healthy consenting patients meeting our inclusion criteria were selected for the trial and randomly allotted into one of two groups of 30 each to receive intrathecally isobaric 0.5% Ropivacaine or isobaric 0.5% Levobupivacaine respectively. Characteristics of sensory and motor nerve block, intra-operative haemodynamic changes and adverse effects such as hypotension, bradycardia, vomiting, shivering were evaluated. The demographic quantitative data was analyzed by student’s t’ test and qualitative data was analyzed by Chi-square test using MEDCALC software. Results: Isobaric Levobupivacaine had a significantly similar onset and progression of sensory block and height of sensory blockade after 20min as compared to the isobaric Ropivacaine group. The onset and progression of motor block (modified Bromage scale) were similar in both groups. The duration of sensory and motor block was significantly shorter (P<0.01) in Ropivacaine group (45 ± 5.14 minutes and 139 ± 10.37 minutes) as compared to the Levobupivacaine group (58 ± 9.15 minutes and 172 ± 14.4 minutes). Conclusions: 0.5% isobaric Ropivacaine has shorter duration and similar onset and progression of motor and sensory blockade on comparing with 0.5% isobaric Levobupivacaine intrathecally with comparable haemodynamic changes and complications.