Why the study?
Does levobupivacaine compared to bupivacaine affect QT, QTc, and P wave dispersion durations in parturients undergoing elective cesarean section?
Does levobupivacaine compared to bupivacaine affect QT, QTc, and P wave dispersion durations in parturients undergoing elective cesarean section?
Levobupivacaine and bupivacaine have similar, non-differentiating effects on P wave and QT dispersion during spinal anesthesia for cesarean section.
Supports equivalent cardiac safety of either agent for cesarean spinal anesthesia; confirms similar effects on QT/P-wave dispersion parameters.
Background and Objectives In our study we aimed to investigate the effect of bupivacaine and levobupivacaine on QT, corrected QT (QTc), and P wave dispersion durations during spinal anesthesia in cesarean section. Methods Sixty parturients scheduled for elective cesarean section in ASA I-II risk groups were included in the study. Baseline electrocardiographic (ECG) records of the patients were obtained in the operation room. Heart rate (HR), non-invasive blood pressure (NIBP), peripheral oxygen saturation (SpO2) and respiration rates (RR) were recorded. Venous cannulation was performed with 18G cannula and fluid preload made with 10 mL.kg -1 . Lactated Ringer solution. After fluid preload, second ECG recordings were taken and the patients were randomly separated into two groups. Group B (n = 30) received 10 mg of bupivacaine and Group L (n = 30) received 10 mg of levobupivacaine for spinal anesthesia. ECG recordings were repeated at 1, 5 and 10 minutes after spinal block. HR, NIBP, SpO 2 , RR and sensory block levels were also recorded at the same time intervals. At predetermined time intervals of spinal anesthesia, P wave dispersion (Pwd), QT dispersion (QTd), and QTc dispersion (QTcd) durations were measured from ECG records. QT and QTc durations are calculated with Bazzett formula. Results There was no difference between two groups according to block levels, hemodynamic parameters, Pwd, QTd, QTc and QTcd durations. Conclusion Bupivacaine and levobupivacaine may be preferred in spinal anesthesia in pregnant patients who have extended Pwd and QTcd preoperatively.
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Deniz et al. (2013) studied this question.
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