Comparison of Hyperbaric 0.5% Bupivacaine with Hyperbaric 0.5% Levobupivacaine for Spinal Anaesthesia in Lower Abdominal and Lower Limb Surgeries

Tushar Sapra* and Valsamma Abraham

Introduction: Spinal anaesthesia is widely used around the globe for surgeries involving lower abdomen, pelvis, and lower limbs. Bupivacaine and its S-enantiomer Levobupivacaine are among the most commonly used drugs for subarachnoid block. 

Aims and objectives: The present study is aimed at comparing the efficacy of spinal anaesthesia (SA) performed with hyperbaric 0.5% Bupivacaine and hyperbaric 0.5% Levobupivacaine in patients undergoing lower abdominal and lower limb surgeries. 

Materials and method: This was a double blinded prospective, randomised study conducted on 70 patients aged between 18 to 60 years of either sex, American Society of Anaesthesiologists’ class 1 and 2, posted for elective lower abdominal and lower limb surgeries under spinal anaesthesia for a period of 18 months. Patients were randomly divided into 2 equal groups: Group A patients received intrathecal dose of hyperbaric 0.5% Bupivacaine 2.5 ml(12.5 mg) with 25 ug Fentanyl [3 ml] while Group B patients received an intrathecal hyperbaric 0.5% Levobupivacaine 2.5 ml(12.5 mg) with 25 ug Fentanyl [3 ml]. 

Results: In our study, the intra-operative readings of various hemodynamic variables showed no significant differences among the patients in both the drug groups. The maximum level of sensory blockade as well as motor blockade was achieved earlier in group A patients in comparison to group B. Moreover, the duration of blocks was also found to be longer in patients who received bupivacaine in comparison to levobupivacaine. The time for the first analgesic was significantly delayed in group A patients in comparison to group B, which showed a significantly higher VAS score reading in the early post-operative period in the patients of group B. 

Conclusion: Our study showed that, both intrathecal bupivacaine and levobupivacaine with fentanyl had equally good control of hemodynamic variables during intra-operative period as well as post-operatively. However, the patients who received intrathecal bupivacaine with fentanyl showed an early onset with longer duration of sensory as well as motor block in comparison to those who were administered intrathecal levobupivacaine with fentanyl. Also, in terms of analgesic potency and duration of analgesia, intrathecal bupivacaine showed better results than intrathecal levobupivacaine.

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Published on: Apr 3, 2026 Pages: 6-12

Full Text PDF Full Text HTML DOI: 10.17352/2455-3476.000062
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