Comparison of the effects of intrathecal bupivacaine, levobupivacaine and ropivacaine in lower abdominal surgery: a double-blind, randomized controlled trial using isobaric preparations

Background: Though various local anesthetic agents are widely used intrathecally for lower umbilical surgeries, their efficacy vary even when used in equipotent doses. Objective: The present study has been conducted to compare the efficacy of intrathecal bupivacaine, levobupivacaine and ropivacaine in lower umbilical surgery using isobaric preparations. Study design: Double-blinded randomized controlled trial. Total 93 patients of ASA (American Society of Anesthesiologists) physical status I and II, all female, aged between 18 to 60 years, were randomized into 3 groups receiving 3 ml of 0.5% bupivacaine, 0.5% levobupivacaine and 0.75% ropivacaine in intrathecal route. Results: Between bupivacaine and levobupivacaine groups, there was no significant difference in any parameter (p>0.5) but ropivacaine group had overall delayed onset and early recovery in several parameters. Conclusion: Intrathecal bupivacaine and levobupivacaine showed superior efficacy. We recommend levobupivacaine owing to its safer cardiac profile.