A prospective, randomized, double-blind comparison of epidural levobupivacaine 0.5% with epidural ropivacaine 0.75% for lower limb procedures

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Abstract
Summary Background and objective: This prospective, randomized, observer-blinded study compared onset time and duration of epidural anaesthesia produced by with levobupivacaine and ropivacaine for lower limb surgery. Methods: ASA I–III adult patients undergoing elective lower limb procedures were randomized to receive epidural levobupivacaine 0.5% 15 mL (n = 30) or epidural ropivacaine 0.75% 15 mL (n = 35). A blinded observer evaluated onset time and regression of motor and sensory block, and intraoperative needs for fentanyl supplementation (0.1 mg intravenously). Results: With levobupivacaine, onset time was 29 ± 24 min, with ropivacaine it was 25 ± 22 min (P = 0.41). Complete resolution of motor block required 105 ± 63 min with levobupivacaine and 95 ± 48 min with ropivacaine (P = 0.86). The time for regression of sensory block to T12 was 185 ± 77 min with levobupivacaine and 201 ± 75 min with ropivacaine (P = 0.46). Analgesic supplementation was required in one patient receiving levobupivacaine (3.5%) and in two patients receiving ropivacaine (5.7%) (P = 0.99). Conclusions: In adults undergoing lower limb surgery, levobupivacaine 0.5% 15 mL produces an epidural block with the same clinical profile as ropivacaine 0.75% 15 mL.