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Levobupivacaine and fentanyl for spinal anaesthesia: a randomized trial

Published online by Cambridge University Press:  25 November 2005

Y. Y. Lee ,
K. Muchhal ,
C. K. Chan  and
A. S. P. Cheung
Y. Y. Lee
Affiliation:
Kwong Wah Hospital, Department of Anaesthesiology and Operating Theatre Services, Kowloon, Hong Kong SAR
K. Muchhal
Affiliation:
Kwong Wah Hospital, Department of Anaesthesiology and Operating Theatre Services, Kowloon, Hong Kong SAR
C. K. Chan
Affiliation:
Kwong Wah Hospital, Department of Anaesthesiology and Operating Theatre Services, Kowloon, Hong Kong SAR
A. S. P. Cheung
Affiliation:
Kwong Wah Hospital, Department of Anaesthesiology and Operating Theatre Services, Kowloon, Hong Kong SAR Present address: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR.
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Extract

Summary

Background and objective: Levobupivacaine 0.5% and racemic bupivacaine 0.5% are equally effective in spinal anaesthesia. Fentanyl has been used as an adjunct to racemic bupivacaine in spinal anaesthesia. At the time this study was designed, there was no published study on the intrathecal use of 0.5% levobupivacaine with fentanyl. Methods: This prospective, randomized, double-blind study compared the clinical efficacy, motor block and haemodynamic effects of using 2.6 mL of 0.5% levobupivacaine alone (25 patients) and 2.3 mL of 0.5% levobupivacaine with fentanyl 15 μg in 0.3 mL (25 patients) for spinal anaesthesia in urological surgery. The study solution was injected into the subarachnoid space at the L3–L4 interspace. Results: There were no significant differences between the two groups in the haemodynamic changes, and quality of sensory and motor block. Anaesthesia was adequate and patient satisfaction was good in all cases. Side-effects were minor and infrequent with both regimes. Conclusions: We conclude that 2.3 mL of 0.5% levobupivacaine with fentanyl 15 μg is as effective as 2.6 mL of 0.5% levobupivacaine alone in spinal anaesthesia for urological surgery. Further studies may be directed to find the optimal combination of levobupivacaine and opioid with maximal haemodynamic stability and least motor block.

Keywords

ANAESTHETICS, LOCAL, levobupivacaineANALGESICS, OPIOID, fentanylANAESTHETIC TECHNIQUES, anaesthesia, spinalSURGERY, urological
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 22 , Issue 12 , December 2005 , pp. 899 - 903
Copyright
© 2005 European Society of Anaesthesiology

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