International Journal of Medical Anesthesiology
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P-ISSN: 2664-3766
E-ISSN: 2664-3774
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International Journal of Medical Anesthesiology

2019, Vol. 2, Issue 2, Part A
Efficacy of isobaric levobupivacaine and fentanyl with isobaric Ropivacaine and fentanyl in patients undergoing TURP under subarachnoid block


Author(s): Dr. Yuvaraj MK and Dr. Aiyappa DS

Abstract: Levobupivacaine has similar pharmacodynamic properties of racemic bupivacaine and is documented to be less cardiotoxic and less neurotoxic in cases of accidental intravascular injection and has shorter duration of motor block than racemic bupivacaine. Protein binding of levobupivacaine (97%) is more than that of racemic bupivacaine (95%). There is less free drug circulating in the plasma and acting on other tissues to cause adverse effects and toxicity. Studies have shown that while volumes of distribution and overall clearance of the two drugs are comparable, the clearance of unbound fraction of levobupivacaine is higher. The study includes 30 males in each group (group R and group L) satisfying the inclusion criteria. Group R: 2.6 cc of 0.75% isobaric ropivacaine (19.5mg) with 0.4cc of fentanyl (20 microgram).Group L: 2.6 cc of 0.5% isobaric levobupivacaine (13 mg) with 0.4cc of fentanyl (20 microgram). This study reveals that the intrathecal 2.6ml of 0.75% isobaric ropivacaine with fentanyl 20μg provides adequate anaesthesia for TURP cases. Ropivacaine achieves a longer duration of sensory and motor blockade as compared with 0.5% isobaric levobupivacaine. With the quality and duration of block achieved with ropivacaine, it can be justified to use it for TURP cases. Furthermore, fentanyl as an adjuvant to both ropivacaine and levobupivacaine enhances the duration of the sensory block. The incidence of rescue analgesia was much earlier in patients who received levobupivacaine with Fentany.

DOI: 10.33545/26643766.2019.v2.i2a.24

Pages: 21-26 | Views: 217 | Downloads: 119

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How to cite this article:
Dr. Yuvaraj MK and Dr. Aiyappa DS. Efficacy of isobaric levobupivacaine and fentanyl with isobaric Ropivacaine and fentanyl in patients undergoing TURP under subarachnoid block. International Journal of Medical Anesthesiology. 2019; 2(2): 21-26. DOI: 10.33545/26643766.2019.v2.i2a.24