A comparative study between levobupivacaine and hyperbaricbupivacaine in spinal anesthesia for ambulatory brachytherapyfor carcinoma of the cervix

ObjectiveThis study aimed to assess the clinical efficacy of levobupivacaine in spinal anesthesia for day-case brachytherapy for carcinoma of the cervix.Study designA prospective, randomized, double-blind study was conducted at the Anesthesia Department of Al-Azhar University Hospitals over a period of 6 months.Patients and methodsBetween July 2013 and January 2014, 40 female patients were included in the study after approval of the Local Ethics Committee of Anesthesia and Intensive Care Department of Al-Azhar University. Informed consent was taken from the patients who were randomized into two groups. Bupivacaine group, which included 20 patients who received intrathecal 7.5 mg of 0.5% hyperbaric bupivacaine; and levobupivacaine group, which included 20 patients who received intrathecal 7.5 mg of 0.5% levobupivacaine. About 25 μg fentanyl was added to the local anesthetic solution in both groups through the L3/L4 interspace. The upper level of sensory blockade, two-segment sensory regression, S2 regression, side effects of the local anesthetic used, urination, ambulation, and the duration of hospital stay were assessed.ResultsThere were no significant differences between both groups regarding the level of sensory blockade, the onset of sensory blockade to the T10 dermatome, and side effects of the local anesthetic. The time to two-segment regression, S2 regression, ambulation, and the duration of hospital stay were significantly shorter in the levobupivacaine group (P 0.05). ConclusionThe mixture of 7.5 mg of 0.5% levobupivacaine+25 μg fentanyl given intrathecally was moreeffective as it provided sensory and surgical blockade with minimal side effects and early home discharge in ambulatory brachytherapy for carcinoma of the cervix compared with 7.5 mg of 0.5% hyperbaric bupivacaine+25 μg fentanyl.