Comparative study evaluates postoperative analgesia in laparoscopic cholecystectomy, suggesting levobupivacaine may be more effective than ropivacaine.
Background: There is a lack of research comparing the effectiveness of levobupivacaine with ropivacaine. Despite increasing body of evidence supporting the use of intraperitoneal local anesthetics with dexmedetomidine for postoperative analgesia, analgesic efficacy and duration of action of both drugs may be influenced by minute variations in their pharmacokinetic characteristics and tissue penetration, even when their pharmacodynamic profiles are similar. Objective: To evaluate the clinical effects of levobupivacaine plus dexmedetomidine against ropivacaine plus dexmedetomidine intraperitoneally for postoperative analgesia in patients undergoing laparoscopic cholecystectomy (LC). Materials and Methods: Hospital-based comparative-prospective study was carried out among 60 cases who were undergoing LC. Patients were divided into two groups of 30 each. In Group L, they received levobupivacaine + dexmedetomidine of 0.5% (20 mL) at 1 μg/kg. In Group R, they received 0.5% ropivacaine + dexmedetomidine (20 mL) at 1 μg/kg. After surgery, pain was evaluated using the Visual Analog Scale. Results: Both groups were comparable for age, sex, ASA grade, and mean duration of surgery ( P > 0.05). At 4 h, the pain score was significantly more in ropivacaine group compared to levobupivacaine group ( P < 0.05). Same findings were also noted at movement. Hemodynamic parameters and complications were comparable in two groups at all-time intervals ( P > 0.05). Conclusion: There were significant differences in pain scores at 4 h postoperation both at rest and during movement, with the ropivacaine group experiencing higher pain levels.
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Vaishnavi et al. (2026) studied this question.
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