하지 수술에서 고비중 Levobupivacaine과 Bupivacaine을 사용한 일측성 척추마취의 비교연구

Abstract

Background Levobupivacaine is the isolated S-enantiomer of bupivacaine and may be a favorable alternative to bupivacaine. The author evaluated the clinical efficacy of levobupivacaine relative to bupivacaine in spinal anesthesia. Methods The author randomly allocated 40 ASA physical status Ⅰ or Ⅱ patients undergoing lower limb surgery to do unilateral spinal anesthesia with 8% glucose bupivacaine 4 mg(n=20) or 8% glucose levobupivacaine 4 mg(n=20). Spinal anesthesia was performed at the L3-4 interspace using a 25-gauge whitacre spinal needle. The lateral decubitus position was maintained for fifteen minutes after injection. Results Thirty minutes after injection, strictly unilateral sensory block was present in 60% and 40% of cases in levobupivacaine and bupivacaine group, respectively(P＞0.05) and unilateral motor block was observed in 90% and 85% in levobupivacaine and bupivacaine group, respectively(P＞0.05). Levobupivacaine group had no differences as compared to bupivacaine group for spinal block resolution median time(P＞0.05). Conclusions It was concluded that 8% glucose levobupivacaine 4 mg and 8% glucose bupivacaine 4 mg provided similar spinal block for lower limb surgery without hemodynamic unstability.