Intrathecal bupivacaine or levobupivacaine: Which should be used for elderly patients?

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Gulec D., KARSLI B., ERTUĞRUL F., BİGAT Z., KAYACAN N.

JOURNAL OF INTERNATIONAL MEDICAL RESEARCH, cilt.42, sa.2, ss.376-385, 2014 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 42 Sayı: 2
  • Basım Tarihi: 2014
  • Doi Numarası: 10.1177/0300060513496737
  • Dergi Adı: JOURNAL OF INTERNATIONAL MEDICAL RESEARCH
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Sayfa Sayıları: ss.376-385
  • Anahtar Kelimeler: Elderly patients, spinal anaesthesia, transurethral resection, levobupivacaine, bupivacaine, SPINAL-ANESTHESIA, RACEMIC BUPIVACAINE, ROPIVACAINE, HYPOTENSION
  • Akdeniz Üniversitesi Adresli: Evet

Özet

Objectives To compare two intrathecal anaesthetics, bupivacaine and levobupivacaine, for their effects on motor and sensory blockade and haemodynamics in patients aged 65 years undergoing transurethral resection of the prostate (TUR-P) or transurethral resection of the urinary bladder (TUR-M).

Abstract

Objectives To compare two intrathecal anaesthetics, bupivacaine and levobupivacaine, for their effects on motor and sensory blockade and haemodynamics in patients aged 65 years undergoing transurethral resection of the prostate (TUR-P) or transurethral resection of the urinary bladder (TUR-M). 

Methods Patients scheduled to undergo TUR-P or TUR-M were randomized to receive either 3ml (15mg) 0.5% isobaric levobupivacaine (group L) or 3ml (15mg) of 0.5% hyperbaric bupivacaine (group B) for spinal anaesthesia. The onset time, maximum level and time to reach the maximum level of sensory and motor blockade were recorded. Changes to haemodynamic parameters were also recorded. 

Results The study randomized 100 patients: 57 to group L and 43 to group B. Levobupivacaine did not cause any significant changes in haemodynamic parameters, including systolic blood pressure, and showed a similar sensory block onset time compared with bupivacaine, but it had a significantly longer motor block onset time compared with bupivacaine. 

Conclusion These current findings suggest that levobupivacaine can be used as a substitute for bupivacaine for spinal anaesthesia in elderly patients 65 years of age undergoing elective TUR-P or TUR-M operations.