January 3, 2025CureusOpen Access

A Double-Blind Randomized Controlled Trial Comparing Intrathecal 0.5% Isobaric Levobupivacaine With Fentanyl to 0.5% Isobaric Ropivacaine With Fentanyl for Elective Cesarean Section

Q: What is the clinical evidence from this study?

Study design: RCT. Population: Elective cesarean section (n=60). Intervention: 0.5% isobaric levobupivacaine with fentanyl vs. 0.5% isobaric ropivacaine with fentanyl. Primary outcome: Time of the onset of sensory block (minutes) (p=<0.001).

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Key result

Intrathecal 0.5% isobaric levobupivacaine with fentanyl provided a significantly faster onset of sensory block (1.29 vs 1.51 minutes) compared to 0.5% isobaric ropivacaine with fentanyl.

Why the study?

The study was designed to compare the onset, duration of action, and sensory and motor block levels between 0.5% isobaric levobupivacaine with fentanyl and 0.5% isobaric ropivacaine with fentanyl in subarachnoid block for elective cesarean section.

Does intrathecal 0.5% isobaric levobupivacaine with fentanyl compared to 0.5% isobaric ropivacaine with fentanyl alter the onset and duration of sensory and motor blocks in women undergoing elective cesarean section?

Comparison

0.5% isobaric levobupivacaine with fentanyl vs 0.5% isobaric ropivacaine with fentanyl

Design

Double-blind randomized controlled trial

Authors

DJDisha Juneja KVKalpana VermaGandhi Medical College & Hospital SSSapna SinghGandhi Medical College & Hospital

Discussion

Member takes

Implication

Levobupivacaine may speed onset in cesarean spinals; extends RCT data on isobaric agents with fentanyl but leaves optimal selection open.

Study Design

Type

RCT (n=60)

Blinding

Double-blind

Randomization

Randomized using sealed opaque envelopes

Multicenter

Structured PICO

Population

60 women at >37 weeks gestation undergoing elective cesarean section were randomized to receive spinal anesthesia with either levobupivacaine or ropivacaine and monitored for 24 hours.

Intervention

10 mg 0.5% isobaric levobupivacaine (2.0 mL) + 25 mcg fentanyl (0.5 mL) administered intrathecally.

Comparator

10 mg 0.5% isobaric ropivacaine (2.0 mL) + 25 mcg fentanyl (0.5 mL) administered intrathecally.

Outcome

Onset and duration of action and the levels of sensory and motor blocks.surrogate

Main Result

Absolute Event Rate: 1.29% vs 1.51%

p-value: p=<0.001

Intrathecal levobupivacaine provides a faster onset of sensory and motor block, whereas ropivacaine offers a shorter duration of motor block and greater hemodynamic stability during elective cesarean sections.

Limitations

Single-center design may restrict the generalizability of findings
Relatively small sample size could limit statistical power
Does not address longer-term outcomes or effects
Single-center design restricting generalizability
Relatively small sample size limiting statistical power

Cite This Study

Juneja et al. (2025) conducted an RCT in Elective cesarean section (n=60). 0.5% isobaric levobupivacaine with fentanyl vs. 0.5% isobaric ropivacaine with fentanyl was evaluated on Time of the onset of sensory block (minutes) (p=<0.001). Intrathecal 0.5% isobaric levobupivacaine with fentanyl provided a significantly faster onset of sensory block (1.29 vs 1.51 minutes) compared to 0.5% isobaric ropivacaine with fentanyl.

synapsesocial.com/papers/6a86ee71540b033b21befce7 https://doi.org/10.7759/cureus.76846

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A Double-Blind Randomized Controlled Trial Comparing Intrathecal 0.5% Isobaric Levobupivacaine With Fentanyl to 0.5% Isobaric Ropivacaine With Fentanyl for Elective Cesarean Section

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

A Double-Blind Randomized Controlled Trial Comparing Intrathecal 0.5% Isobaric Levobupivacaine With Fentanyl to 0.5% Isobaric Ropivacaine With Fentanyl for Elective Cesarean Section

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

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