Comparison of Racemic Bupivacaine and Levobupivacaine; combined with low dose Fentanyl, through Intrathecal Route for Transurethral Resection of Prostate

Description

Background and Objectives: Bupivacaine is available as a racemic mixture of dextro and levobupivacaine. Many studies show that dextrobupivacaine has greater cardiovascular and central nervous system toxicity than levobupivacaine. The objectives of the present study were to compare the effects of racemic Bupivacaine + Fentanyl and Levobupivacaine + Fentanyl on the complete regression of motor block, onset time to reach T10 level sensory block, duration of T10 level sensory block, onset time of motor block, duration of sensory block.
Materials and Method: The study was conducted in 100 patients undergoing transurethral resection of prostate operation, who received either 1.75 ml Bupivacaine (0.5%) + 25µg Fentanyl (Gr A) or 1.75 ml Levobupivacaine (0.5%) + 25µg Fentanyl (Gr B) intrathecally.
Results: Time to complete regression of motor block, onset time toT10 level sensory block were significantly prolonged in Gr A compared to Gr B. The onset time of motor block was significantly shorter in Gr A compared to Gr B. There was no statistically significant difference between the two groups in respect to the duration of T10 level sensory block, duration of sensory block.
Conclusion: Intrathecal Levobupivacaine + Fentanyl used in the present study can be considered as a suitable alternative to Bupivacaine + Fentanyl for spinal anaesthesia in elective TURP surgery.