Levobupivacaine Versus Ropivacaine Infiltration Analgesia for Mastopexy

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Abstract
A prospective double-blind study was conducted to compare the analgesic properties of levobupivacaine and ropivacaine in a bilaterally symmetrical mastopexy model. Both of these 2 long-acting local anesthetic amides are associated with lower cardiac and central nervous system toxicity than racemic bupivacaine, a widely used agent for long-lasting perioperative analgesia in esthetic procedures. In this study, each of the 18 patients undergoing bilateral mastopexy under conscious sedation received preoperative infiltration with levobupivacaine in 1 breast and equal volume of ropivacaine in the other. Patients were requested to assess their pain separately in each side every 2 hours and for 12 hours postoperatively on a visual analog scale. Overall analgesia achieved up to 12 hours postoperatively was found to be statistically different between the 2 local anesthetic factors in favor of levobupivacaine. At 2 hours postoperatively, no difference was found between the 2 local anesthetic agents in terms of analgesic efficacy (P = 0.298). However, postoperative pain scores recorded after infiltration with levobupivacaine were significantly lower than pain scores for the ropivacaine-infiltrated sides (P It is concluded that levobupivacaine is more effective for local infiltrative analgesia in mastopexy than ropivacaine, providing longer-lasting postoperative analgesia.

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