ABSTRACT

The aim of this study is to compare the effects of intrathecal levobupivacaine and bupivacaine in caesarean operations.

A randomised, double-blind study was applied to 60 ASA I-II, 18-40 year-old women scheduled for caesarean section; levobupivacaine patients in Group L (n=30) and bupivacaine applied Group B (n=30) were used. In the sitting position, L3-4 or L4-5 level, with a combined spinal-epidural anaesthesia technique, spinal anaesthesia was administered. In Group L: 11 mg isobaric levobupivacaine, and in Group B 11 mg hyperbaric bupivacaine was injected intratechally. The sensory block and motor block onset time, a one level lower degree time of motor block, two segment regression time of sensory block, the first analgesic requirement, the side effects such as nausea, vomiting, hypotension and bradycardia were recorded.

The time to reach the T4-6 level in Group L was significantly longer than group B; regression time to level T12 was significantly shorter in Group L (p<0.05). The first analgesic requirement in Group L was statistically significantly shorter than Group B (p<0.05). Motor block regression time was statistically significantly longer in Group B than Group L (p<0.05).

In caesarean section, early motor and sensory block is an advantage but prolonged motor block is a disadvantage as discharge to the ward and breast feeding is delayed. Due to the early onset of sensory and motor block, bupivacaine seems to be superior to levobupivacaine. However, the motor block is longer with bupivacaine and levobupivacaine has less cardiac side effects. Because of this, we believe that more comprehensive, randomised controlled trials need to be done in spinal anaesthesia of caesarean cases with a choice of local anaesthetics.

Keywords: Anestezi, spinal, epidural, levobupivakain, obstetrik