Levobupivacaine 0.5% Provides Longer Analgesia After Sciatic Nerve Block Using the Labat Approach Than the Same Dose of Ropivacaine in Foot and Ankle Surgery

Fournier, Roxane; Faust, Alexandre; Chassot, Olivier; Gamulin, Z.

doi:10.1213/ane.0b013e3181d3e80b

Cited by 28 publications

(32 citation statements)

References 8 publications

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“…Cline et al and Fournier et al had made similar observations. 14,15 In the present study, intra operative and postoperative haemodynamic parameters were also studied. The pulse rate, systolic blood pressure, diastolic blood pressure and oxygen saturation were comparable in both the groups' intra operatively and post operatively.…”

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confidence: 99%

Comparison of levobupivacaine with ropivacaine for supraclavicular brachial plexus block

2016

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INTRODUCTIONRecently peripheral nerve block anaesthesia has become popular against general anaesthesia as it is devoid of side effects of intubation and muscle relaxants and systemic haemodynamic changes. This type of anaesthesia is particularly advantageous in case of prolonged orthopedic, plastic reconstructive surgeries and in emergency surgeries where the patients are full stomach, not adequately starving and in high risk patients. This technique not only provides anaesthesia but also postoperative analgesia. 1Peripheral nerve block anaesthesia had many advantages over general anaesthesia such as cost effective, favourable postoperative recovery profile, preserves CNS functions and prevents complications of intubation, laryngoscopy and muscle relaxants. Recently nerve ABSTRACT Background: Peripheral nerve blocks have assumed a prominent role in modern anaesthesia practice as they provide ideal operative conditions without any general anaesthesia or adverse haemodynamic effects. When compared with ropivacaine, levobupivacaine is a newer, safer, longer acting local anaesthetic with rapid onset and prolonged duration of analgesia and similar or more pronounced nerve blocking effects, depending on the concentration. Hence the present study is aimed to compare the effectiveness of 0.5% levobupivacaine and 0.5% ropivacaine in supraclavicular brachial plexus block. Methods: The present study was a prospective, randomized, double blind comparative study of 60 patients with ASA grade I, II of either sex, between the ages 18 years to 60 years. They were enrolled and randomly divided into two groups. Supraclavicular brachial plexus block was given for upper limb surgeries using 0.5% levobupivacaine (Group L) or 0.5% ropivacaine (Group R). The onset of sensory and motor block, their duration, and possible adverse events were recorded and compared for both groups. Results: Significant earlier onset of sensory blockade (p=0.027) and motor blockade (p=0.01), prolonged duration of sensory and motor blockade (p=0.0001) was observed in group of patients receiving levobupivacaine compared to ropivacaine. The time for first rescue analgesia required post operatively was much longer in Group L(13.2333±1.1651hr) as compared to Group R(10.8667±0.91852 hr) and the difference was significant (p=0.0001).Intraoperatively throughout the study heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were comparable in both the groups and found no statistically significant difference (p >0.05). The heart rate, systolic and diastolic blood pressure for both the groups were compared postoperatively and observed no statistical significant difference (p >0.05). No adverse effects were observed in both the groups. Conclusions: 0.5% levobupivacaine used in supraclavicular brachial plexus block for upper limb surgeries provides rapid onset of sensory and motor blockade and prolonged duration of analgesia compared to 0.5% ropivacaine.

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Comparison of levobupivacaine with ropivacaine for supraclavicular brachial plexus block

2016

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“…Levobupivacaine administered via a peripheral nerve block continuous catheter provides excellent post-operative analgesia and decreases the post-operative systemic opioids requirements . (13,14,15,16) It has been postulated that presynaptic activation of alpha-2A adrenoceptor in the locus ceruleus inhibits the release of nor-epinephrine and results in the sedative and hypnotic effects and terminates the propagation of pain signals leading to analgesia. High selectivity for alpha 2A receptors mediates analgesia, sedation and anxiolysis.…”

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confidence: 99%

Dexmedetomidine and Clonidine as Adjuvants to Levobupivacaine in Supraclavicular Brachial Plexus Block: A Comparative Randomised Prospective Controlled Study

Gunasekaran¹,

Sudheer²,

Sahajananda³

et al. 2015

jemds

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BACKGROUND:There are always efforts to find better and safer local anaesthetics along with adjuvants for supraclavicular brachial plexus block. Levobupivacaine, has strongly emerged as a safer alternative for regional anesthesia than its racemic sibling, bupivacaine. Alpha 2 agonists are combined with local anaesthetics to improve the quality of regional anesthesia. AIMS AND OBJECTIVES: This study was conducted to evaluate and compare the onset, duration of sensory and motor blockade along with the duration of analgesia between dexmedetomidine and clonidine when administered along with 0.5% levobupivacaine in supraclavicular brachial plexus block for upper limb orthopaedic surgeries. MATERIALS AND METHODS: A prospective randomized study was carried out in the department of Anaesthesia at Rajarajeswari Medical College and Hospital which included 50 adult patients between the ages of 20 and 50 years (of ASA I/II grade) who underwent upper limb orthopaedic surgeries. The patients were randomly allocated into two groups; levobupivacaine + dexmedetomidine (LD) and levobupivacaine + clonidine (LC), comprising of 25 patients each. Group LD was administered 30 ml of 0.5% levobupivacaine and 1µg/kg of dexmedetomidine, while group LC received admixture of 30 ml of 0.5% levobupivacaine and 1 µg/kg of Clonidine. Onset, duration of sensory and motor blockade and duration of analgesia were observed. STATISTICAL ANALYSIS: Statistical analysis was done using student t test, chi-square test and Fisher Exact test. The Statistical Software namely SAS 9.2, SPSS 15.0, Stata 10.1, MedCalc 9.0.1, Sysatat 12.0 and R environment ver.2.11.1 were also used for the analysis of the data and Microsoft word and Excel have been used to generate graphs, tables etc. The value of P <0.05 was considered significant and P < 0.001 as highly significant. RESULTS: The onset of sensory and motor blockade was faster in Group LD when compared to Group LC. The duration of sensory blockade, motor blockade and analgesia was longer in Group LD when compared to Group LC (p <0.001). Sedation scores were better in LD group. (p<0.05). CONCLUSION: Dexmedetomidine is a better adjuvant than Clonidine when added to Levobupivacaine in supraclavicular brachial plexus block as it prolongs the duration of sensory and motor blockade as well as the duration of analgesia.

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“…1 A recent clinical trial comparing levobupivacaine 0.5% with ropivacaine 0.5% for the management of postoperative ankle surgery pain found that levobupivacaine provide more long lasting postoperative analgesia compared with the same dose of ropivacaine, in contrast McNamee et al reported that intrathecal administration of 17.5 mg plain ropivacaine 0.5% or plain bupivacaine 0.5% resulted in similarly effective anesthesia for total hip arthroplasty. 2,3 We have planned the study to evaluate effect of plain ropivacaine 0.5% versus plain levobupivacaine 0.5% in gynecological surgeries.…”

Section: Introductionmentioning

confidence: 99%

Comparative study of ropivacaine (0.5%) plain versus levobupivacaine (0.5%) plain in gynecological surgeries

Jain

Bendwal

Deodhar

et al. 2017

Int J Reprod Contracept Obstet Gynecol

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Background: Regional anesthesia increasingly used for gynecological surgeries, has advantage of decreased stress response to surgery, decreased cardiorespiratory depression, with improved postoperative analgesia.Methods: This randomized, prospective, double blind study was conducted at Amaltas Institute of Medical Sciences, Banger Dewas in Department of Anesthesia between June 2016-December 2016. Sixty patients who were posted for gynecological surgeries were enrolled and randomly divided into two groups: Group R received 3.5 ml (17.5 mg) 0.5% ropivacaine plain and Group L received 3.5 ml (17.5 mg) 0.5% levobupivacaine plain. The onset and duration of sensory and motor block and any undesirable side effects were noted.Results: Demographic parameters were comparable between the two groups (P >0.05). Onset of sensory and motor block was significantly faster in Group L, duration of motor and sensory block was significantly less in Group R. Patients in group R were hemodynamically stable (P = 0.032) compared to group L.Conclusions: Both ropivacaine and levobupivacaine have the desirable blocking property and can be used in gynecological surgeries. Ropivacaine showed shorter duration of sensory and motor block allowed early mobilization and early recovery of patients.

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Levobupivacaine 0.5% Provides Longer Analgesia After Sciatic Nerve Block Using the Labat Approach Than the Same Dose of Ropivacaine in Foot and Ankle Surgery

Abstract: Twenty milliliters levobupivacaine 0.5% in posterior gluteal (Labat) sciatic nerve block provided longer-lasting analgesia after foot and ankle surgery compared with the same dose of ropivacaine.

Cited by 28 publications

References 8 publications

Comparison of levobupivacaine with ropivacaine for supraclavicular brachial plexus block

Comparison of levobupivacaine with ropivacaine for supraclavicular brachial plexus block

Dexmedetomidine and Clonidine as Adjuvants to Levobupivacaine in Supraclavicular Brachial Plexus Block: A Comparative Randomised Prospective Controlled Study

Comparative study of ropivacaine (0.5%) plain versus levobupivacaine (0.5%) plain in gynecological surgeries

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