Randomized Double Blind Study To Compare Hemodynamic Profile Of Intrathecal Hyperbaric Bupivacaine 0.5 percent Versus Hyperbaric Levobupivacaine 0.5 percent in Elderly Population Undergoing Infraumbilical Surgeries.

Spinal anaesthesia has been a popular anaesthesia technique. Hyperbaric

racemic bupivacaine is commonly used for spinal anaesthesia due to its

long duration of action and combined motor and sensory blockade.

However, the use of hyperbaric racemic bupivacaine in spinal anaesthesia

has some drawbacks. It has a high propensity to cause hypotension and

bradycardia following intrathecal injection and there is likely potential

for cardiac toxicity due to the high affinity of bupivacaine to cardiac

myocytes.

Levobupivacaine has a lower affinity for cardiac sodium channels and

greater plasma protein binding affinity compared with the dextro isomer

so reducing the risk of cardio-toxicity and decreasing the incidence of

hypotension and bradycardia.

Levobupivacaine also results in earlier motor recovery compared with

bupivacaine and also has less central nervous system toxicity.

These advantages make Levobupivacaine an safer alternative to

bupivacaine for spinal anaesthesia in high risk and elderly population.

It is currently known that levobupivacaine and bupivacaine have similar

analgesic potentials for Central Neuroaxial block and Peripheral Nerve

block.