ISOBARIC LEVOBUPIVACAINE VERSUS HYPERBARIC BUPIVACAINE IN PREGNANT WOMEN UNDERGONE CESAREAN SECTIONS: A RANDOMIZED CONTROLLED TRIAL

Authors

  • A AMJAD Department Of Anesthesia, MTI-Lady Reading Hospital, Peshawar, Pakistan
  • H SADIA Khyber Medical College, Peshawar, Pakistan
  • M SAAD Khyber Medical College, Peshawar, Pakistan
  • A ALI Department of Anesthesia, MTI-Lady Reading Hospital, Peshawar, Pakistan
  • A NAEEM Khyber Medical College, Peshawar, Pakistan
  • H NAEEM Department of Anesthesia, MTI-Lady Reading Hospital, Peshawar, Pakistan
  • M AHMED Department of Dermatology, MTI-Lady Reading Hospital, Peshawar, Pakistan

DOI:

https://doi.org/10.54112/bcsrj.v2023i1.431

Keywords:

Caesarean section, Bupivacaine, Spinal anesthesia, Comparison

Abstract

 To compare isobaric levobupivacaine versus hyperbaric bupivacaine for pregnant women who have undergone cesarean sections. In this randomized controlled trial, 70 patients with ASA physical status I-II, scheduled i.e for elective lower segment cesarean section (LSCS), were divided into two equal-sized groups (n = 35 each). Group A was treated with 2.5 ml of isobaric levobupivacaine, while Group B was treated with 2.5 ml of hyperbaric bupivacaine. Both groups' sensory and motor block features were evaluated using the pinprick test and the Bromage scale. Additionally, any instances of hypotension and potential side effects were meticulously recorded. Subsequently, the collected data underwent statistical analysis employing appropriate tests. The initiation of sensory blockage was observed to be slower, and the regression duration for two segments was extended while using isobaric levobupivacaine (p < 0.001). Nevertheless, it generated sufficient surgical anesthetic with a reduced duration of motor blocking and fewer side effects compared to hyperbaric bupivacaine.  This study concludes that single-shot spinal anesthesia with different local anesthetics is effective for prompt surgical anesthesia induction in elective cesarean section procedures. Among these options, levobupivacaine is a superior choice due to its smaller duration of motor block, reduced side effects, and lower risk of hypotension, making it particularly well-suited for such procedures.

Downloads

Download data is not yet available.

References

Agarwal, A., and Kishore, K. (2009). Complications and controversies of regional anaesthesia: a review. Indian Journal of Anaesthesia 53, 543.

Antoine, C., and Young, B. K. (2021). Cesarean section one hundred years 1920–2020: the Good, the Bad and the Ugly. Journal of Perinatal Medicine 49, 5-16.

Atalay, C., Karaca, M., Naldan, M. E., Soyalp, C., and Kursad, H. (2018). Fentanyl with low dose bupivacaine (isobaric and hyperbaric) and levo bupivacaine for combined spinal-epidural technique in cesarean section. Medicine Sci 7, 494-98.

Bajwa, S. J. S., and Kaur, J. (2013). Clinical profile of levobupivacaine in regional anesthesia: A systematic review. Journal of anaesthesiology, clinical pharmacology 29, 530.

Bidikar, M., Mudakanagoudar, M. S., and Santhosh, M. (2017). Comparison of intrathecal levobupivacaine and levobupivacaine plus fentanyl for cesarean section. Anesthesia, essays and researches 11, 495.

Deori, A. K., Das, A., Borgohain, D., Bora, D., Saikia, A., and Tiwari, P. K. (2016). A comparative study of spinal anaesthesia with levobupivacaine and hyperbaric bupivacaine for cesarean sections. International Journal of Contemporary Medical Research 3, 1902-5.

Durodola, A. O., Adekola, O. O., Agbamu, P. A., Akinwilliams, O. O., and Olatosi, J. O. (2021). Maternal hypotension and fetal outcome: effect of height-adjusted and weight-adjusted dose versus fixed dose of 0.5% intrathecal hyperbaric bupivacaine. Research & Opinion in Anesthesia & Intensive Care 8.

Fakherpour, A., Ghaem, H., Fattahi, Z., and Zaree, S. (2018). Maternal and anaesthesia-related risk factors and incidence of spinal anaesthesia-induced hypotension in elective caesarean section: A multinomial logistic regression. Indian journal of anaesthesia 62, 36.

Goffard, P., Leloup, R., Vercruysse, Y., Fils, J.-F., Gautier, P. E., and Kapessidou, Y. (2022). Comparison of equipotent doses of intrathecal hyperbaric prilocaine 2% and hyperbaric bupivacaine 0.5% for elective caesarean section: A prospective, randomised, controlled, two-centre clinical trial. European Journal of Anaesthesiology| EJA 39, 227-235.

Horlocker, T. T., Wedel, D. J., Rowlingson, J. C., Enneking, F. K., Kopp, S. L., Benzon, H. T., Brown, D. L., Heit, J. A., Mulroy, M. F., and Rosenquist, R. W. (2010). Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines. Regional Anesthesia & Pain Medicine 35, 64-101.

Jelting, Y., Klein, C., Harlander, T., Eberhart, L., Roewer, N., and Kranke, P. (2017). Preventing nausea and vomiting in women undergoing regional anesthesia for cesarean section: challenges and solutions. Local and regional anesthesia, 83-90.

Jenkins, J., and Khan, M. (2003). Anaesthesia for Caesarean section: a survey in a UK region from 1992 to 2002. Anaesthesia 58, 1114-1118.

Lee, Y. Y., Kee, W. D. N., Fong, S. Y., Liu, J. T., and Gin, T. (2009). The median effective dose of bupivacaine, levobupivacaine, and ropivacaine after intrathecal injection in lower limb surgery. Anesthesia & Analgesia 109, 1331-1334.

Maheshwari, N., Gautam, S., Kapoor, R., Prakash, R., Jafa, S., and Gupta, R. (2019). Comparative study of different doses of clonidine as an adjuvant with isobaric levobupivacaine for spinal anaesthesia in patients undergoing caesarean section. Journal of Obstetric Anaesthesia and Critical Care 9, 9-13.

Manassero, A., and Fanelli, A. (2017). Prilocaine hydrochloride 2% hyperbaric solution for intrathecal injection: a clinical review. Local and regional anesthesia, 15-24.

Manouchehrian, N., Rahimi-Bashar, F., Pirdehghan, A., and Shahmoradi, F. (2022). Comparison between 10 and 12 mg doses of intrathecal hyperbaric (0.5%) bupivacaine on sensory block level after first spinal failure in cesarean section: A double-blind, randomized clinical trial. Frontiers in Medicine 9, 937963.

Rao, D. G., Anand, S., and Pasha, N. (2020). Comparative study of isobaric levobupivacaine and hyperbaric bupivacaine for subarachnoid block in elective cesarean sections. Anaesthesia, Pain & Intensive Care 24, 215-222.

Sreekanth, R., and Totawar, S. R. (2018). Comparison of the effects of lateral and sitting position during induction of spinal anaesthesia with plain levobupivacaine in caesarean section. Indian Journal of Clinical Anaesthesia 5, 86-91.

Downloads

Published

2023-10-02

How to Cite

AMJAD, A., SADIA, H., SAAD, M., ALI, A., NAEEM, A., NAEEM, H., & AHMED, M. (2023). ISOBARIC LEVOBUPIVACAINE VERSUS HYPERBARIC BUPIVACAINE IN PREGNANT WOMEN UNDERGONE CESAREAN SECTIONS: A RANDOMIZED CONTROLLED TRIAL. Biological and Clinical Sciences Research Journal, 2023(1), 431. https://doi.org/10.54112/bcsrj.v2023i1.431

Most read articles by the same author(s)

1 2 3 > >>