Evaluation of levobupivacaine and bupivacaine cardiotoxicities by correlation of Brain Natriuretic Peptide protein values and arterial pressures

Objectives: The aim of the present study was to determine the cardiotoxic effects of the intrathecal and epidural administration of bupivacaine and levobupivacaine by investigating whether there is a correlation between the brain natriuretic peptide (BNP) protein levels and the arterial pressure. Methods: In this prospective, randomized, double-blinded, 30 patients aged 25-70 years, who were undergo total knee arthroplasty surgery, were randomized into 2 groups. In Group 1 (n=15): levobupivacaine was applied and Group 2 (n = 15) bupivacaine was applied. Primary outcome measures includes BNP protein levels (at after injection 10th minute and postoperative 24th hour), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), mean arterial pressure (MAP) (at preoperative, after injection 10th minute and postoperative 24th hour) was examined. Results: In both groups, there was no statistically significant correlation between the BNP levels and the SAP, DAP and MAP value 10 minutes after the administration of combined spinal-epidural anesthesia and at the 24th hour (p>0.05) Conclusions: We think that the cardiac effects associated with the hypotensive effects of local anesthetics cannot be revealed with the BNP. Moreover, our study results suggest that both drugs are not cardiotoxic when administered with combined epidural spinal anesthesia.