Open AccessComparative Efficacy of Levobupivacaine and Ropivacaine for Epidural Block in Outpatients with Degenerative Spinal Disease
Author(s) -
Takashi Egashira
Publication year - 2014
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2014/17/525
Subject(s) - levobupivacaine , medicine , ropivacaine , anesthesia , visual analogue scale , sciatica , blood pressure , heart rate , hemodynamics , surgery , urination , bupivacaine , urinary system
Background: Levobupivacaine has less toxic potential on both the cardiovascular andcentral nervous system and has been widely used for postoperative epidural analgesia insurgical patients. However, there are few reports on the efficacy of epidural levobupivacainein outpatients with lumbosacral radiculopathy. This study was carried out to evaluate thecomparative efficacy of levobupivacaine and ropivacaine for epidural block in outpatients withdegenerative spinal disease and sciatica.Objective: We studied 32 patients (19 men and 13 women) with degenerative spinaldisease and sciatica.Study Design: The study was performed in a prospective, randomized, double blind, andcrossover fashion.Setting: University medical facility.Methods: The epidural block was produced with a caudal approach (0.125% levobupivacaineor 0.2% ropivacaine, 15 mL). The upper level of analgesia, lumbosacral pain, motor blockade,and hemodynamic changes were evaluated by pin prick, visual analogue scale (VAS), Bromagescale, and arterial blood pressure and heart rate at 15, 30, 60, and 90 minutes after epiduralblock, respectively. The recovery time to mobilization, ambulation, and spontaneous micturitionwere measured.Results: There were no significant differences (P < 0.05) in the upper level of analgesia,VAS, and Bromage scale between 0.125% levobupivacaine and 0.2% ropivacaine throughoutthe time course. There were no significant differences in the recovery times to mobilization,ambulation, and spontaneous micturition between 0.125% levobupivacaine and 0.2%ropivacaine. There were no significant differences in arterial blood pressure and heart ratebetween the 2 trials throughout the time course.Conclusion: The results showed that 0.125% levobupivacaine and 0.2% ropivacaine forepidural block by a caudal approach provide similar lumbosacral pain relief, hemodynamiceffects, and the degree and the recovery of motor blockade in outpatients with degenerativespinal disease and sciatica.Key words: Levobupivacaine, ropivacaine, outpatients, epidural block, degenerativespinal disease with sciatica