Why the study?
Levobupivacaine is a relatively new drug, and studies evaluating it in supraclavicular blocks are limited.
Does levobupivacaine improve block characteristics and prolong post-operative analgesia compared to ropivacaine in adult patients undergoing orthopedic forearm surgery?
Does levobupivacaine improve block characteristics and prolong post-operative analgesia compared to ropivacaine in adult patients undergoing orthopedic forearm surgery?
Levobupivacaine provides faster onset of sensory block and prolonged post-operative analgesia compared to ropivacaine in ultrasound-guided supraclavicular blocks for forearm surgery.
Levobupivacaine may provide faster sensory onset and longer analgesia than ropivacaine; leaves open need for larger confirmatory trials before practice change.
Levobupivacaine is relatively new drug and studies in supraclavicular blocks are limited. Our Primary aim was to evaluate and compare block characteristics and post operative analgesia of Levobupivacaine with Ropivacaine in supraclavicular block. Secondary aim was to compare systemic toxicity profiles of both drugs. Totally 60 adult patients were randomly allocated to two equal groups (n = 30). Patients in Group-R received 20 ml 0.5% ropivacaine and Group-L received 20 ml 0.5% Levobupivacaine in ultrasonography guided supraclavicular block. The main objective was to evaluate block characteristics and the duration of analgesia and other were hemodynamic variables, sedation score, and adverse effects. The data were interpreted with the help of t-test and Chi-square test. Onset time, Peak effect time and total duration of sensory block was 90.33± 35.43 sec, 379.67 ± 201.21sec and 428.5± 94.19 min in Group L while it was 192.33± 65.21 sec, 484± 202.05 sec and 345.17± 104.59 min in Group-R respectively. (P value < 0.05). Onset time and total duration of motor block was 265.67 ± 117.9 sec and 331 ± 93.13 min. in Group L while it is 283.± 122.73 sec and 310± 99.83 min in Group R (p ≥ .05) The duration of post-operative analgesia was 12±2.12 hr in group L and 7.7±1.9 hr. in group R (p value < .001). Levobupivacaine (0.5% 20 ml) can be safely and effectively used in ultrasound guided supraclavicular block and it has early onset with prolonged duration of anaesthesia as well as prolonged post-operative pain relief compare to Ropivacaine.
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Pandya et al. (2020) studied this question.
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