Key result
Levobupivacaine 0.5% linked to ~26% longer analgesia but slower motor block onset vs ropivacaine 0.5%.
Why the study?
Does levobupivacaine improve the duration of analgesia compared to ropivacaine in patients undergoing upper limb surgeries with supraclavicular brachial plexus block?
Does levobupivacaine improve the duration of analgesia compared to ropivacaine in patients undergoing upper limb surgeries with supraclavicular brachial plexus block?
Levobupivacaine provides a longer duration of analgesia but has a slower onset of motor blockade compared to ropivacaine for supraclavicular brachial plexus block.
May support levobupivacaine for longer analgesia in this cohort; leaves open confirmation via randomized trials before practice change.
Background: To compare the clinical profiles of levobupivacaine and ropivacaine at equipotent doses for supraclavicular brachial plexus block for upper limb surgeries, we hypothesized that both will induce a similar upper limb anesthetic blockade in terms of sensory and motor blockades. Objective: To evaluate the effects of levobupivacaine and compare it with ropivacaine in brachial plexus block through supraclavicular route. Materials and Methods: For this prospective study, 60 patients of both sexes ASA I/II were enrolled and divided into two groups, and supraclavicular brachial plexus block was performed using levobupivacaine 0.5% and ropivacaine 0.5% using classical approach. The onset of sensory and motor block, their duration, and possible adverse events were recorded. Result: No statistically significant difference was observed in the onset of sensory block in both the groups. Onset of motor blockade was significantly faster with ropivacaine (9.50 ± 2.403 min) as compared to levobupivacaine (12.33 ± 2.537 min; P < 0.05). Duration of sensory and motor block was significantly short for ropivacaine than levobupivacaine (P < 0.05). Levobupivacaine has significantly longer duration of analgesia (12.56 ± 1.30 h) as compared to ropivacaine (9.93 ± 1.7 h; P < 0.05). Conclusion: Levobupivacaine, a novel long-acting local anesthetic agent, having better profile in terms of duration of analgesia, with a considered disadvantage of delayed wearing off of motor blockade, offers an alternative to ropivacaine for brachial plexus block in upper limb surgeries.
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Mankad et al. (2015) studied upper limb surgeries (n=60). Levobupivacaine vs. Ropivacaine 0.5% was evaluated on duration of analgesia (hours) (p=< 0.05). Levobupivacaine 0.5% provided a significantly longer duration of analgesia (12.56 vs 9.93 hours; P<0.05) but had a slower onset of motor blockade compared to ropivacaine 0.5%.
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