Comparison of the anesthetic effects of intrathecal levobupivacaine + fentanyl and bupivacaine + fentanyl during caesarean section

Abstract

Background: Regional anesthesia techniques are increasingly preferred for caesarean section. The aim of the present study was to compare the anesthetic effects of levobupivacaine + fentanyl and bupivacaine + fentanyl on the mother and newborn during elective caesarean section under spinal anesthesia.

Methods: In this prospective study, 50 gravidas, who were scheduled for cesarean section were enrolled after Ethics Committee approval had been obtained. The patients were randomized into one of the following two groups: bupivacaine + fentanyl group (group B; n = 25), 7.5 mg of 0.5% bupivacaine + 15 microg fentanyl intrathecally; levobupivacaine + fentanyl group (group L; n = 25), 7.5 mg of 0.5% levobupivacaine + 15 microg fentanyl intrathecally. The patients were immediately placed in supine position with 20-30 degrees head up-tilt. The level of sensory and motor blocks were evaluated by pin-prick test and Bromage scale, respectively.

Results: The time to sensory block at the T4 dermatome was shorter in group B (group B, 4.8 min; group L, 6.0 min; p < 0.05). The time to maximum motor block was also shorter in group B (group B, 3.4 min; group L, 4.7 min; p < 0.05). The duration of analgesia was longer in group L compared to group B (group B, 102 min; group L, 118 min; p < 0.05).

Conclusions: Time to sensory and maximum motor block was shorter in the bupivacaine + fentanyl group. On the other hand, a longer duration of analgesia was achieved in the levobupivacaine + fentanyl group. Although levobupivacaine is a novel drug, it is a good alternative for bupivacaine.