A Comparison of Levobupivacaine and Ropivacaine for Interscalene and Femoral Nerve Blocks: A Randomized, Double-Blind, Prospective Clinical Trial

Study Objective: To compare the quality of perioperative analgesia provided by levobupivacaine 0.5% and ropivacaine 0.5%. Design: Randomized, double-blind, prospective clinical trial. Setting: Operating room of a university medical center. Patients: Thirty-five patients undergoing shoulder arthroscopy and thirty-six patients undergoing anterior cruciate ligament (ACL) reconstruction. Interventions: Patients undergoing shoulder arthroscopy were administered interscalene blocks, and patients undergoing ACL reconstruction were administered femoral nerve blocks. Patients in each group were randomized to receive either levobupivacaine 0.5% or ropivacaine 0.5%. Measurements: On postoperative days one and two, patients reported on the time of postoperative pain onset, the time when movement resumed in the operative limb, the time when pain medication was first required, and the amount of pain medication used. Patient satisfaction was measured 48 hours after the procedure on a 1–10 verbal numeric rating scale. Main results: Time to onset of anesthesia, intraoperative and postoperative opioid requirements, duration of postoperative analgesia, and overall patient satisfaction were similar between patients who received levobupivacaine and those who received ropivacaine. Conclusions: The study demonstrates that levobupivacaine and ropivacaine produce comparable postoperative analgesia when used for interscalene and femoral nerve blocks.