November 2025, Volume 3, Issue 11

Author

Praveen Kumar Mathanagopal, Pravin Kumar Sekaran, Margaret Theresa J, Selvamani Subramanian, Ravi B and Anbuselvi Anoumandane

Abstract

Levobupivacaine, the S (-) enantiomer of bupivacaine, is known for its reduced cardiotoxicity and central nervous system side effects. The present study was conducted to compare the anesthetic efficacy and safety profiles of two local anesthetic agents-hyperbaric levobupivacaine and hyperbaric bupivacaine-in patients undergoing elective infra-umbilical surgeries. A total of 100 patients classified as ASA Physical Status I-II were randomly assigned to receive subarachnoid block with either hyperbaric levobupivacaine or hyperbaric bupivacaine. Group L (n = 50) received 3 ml of 0.5% hyperbaric levobupivacaine (15 mg), while Group B (n = 50) received 3 ml of 0.5% hyperbaric bupivacaine (15 mg). The onset and duration of sensory and motor blockade, recovery characteristics, hemodynamic changes, and adverse effects were compared between the two groups. The onset of sensory block was faster in Group B compared to Group L. The time for two-segment regression and duration of motor blockade were significantly longer in Group B. However, Group L demonstrated greater hemodynamic stability than Group B. Overall, 0.5% hyperbaric levobupivacaine (15 mg) produced satisfactory sensory and motor blockade with stable hemodynamic parameters and fewer adverse effects than an equivalent dose of hyperbaric bupivacaine. Therefore, hyperbaric levobupivacaine may be considered a safer and effective alternative for subarachnoid block in infra-umbilical surgeries.