[Levobupivacaine for peripheral blocks of the lower limb: a clinical comparison with bupivacaine and ropivacaine]

BACKGROUND: The aim of this study was the comparison of clinical profile of sciatic nerve block performed with either 0,5% levobupivacaine, 0,5% bupivacaine, or 0,5% ropivacaine.

METHODS: With ethical committee approval and written informed consent 45 ASA physical status I-II patients, undergoing elective hallux valgus repair received intravenous premedication with midazolam (0,05 mg/kg) followed by femoral nerve block with 15 ml of 2% mepivacaine. Then patients were randomly allocated to receive a sciatic nerve block with 20 ml of either 0,5% levobupivacaine (n=15), 0,5% bupivacaine (n=15), or 0,5% ropivacaine (n=15). An independent blind observer evaluated the onset time and duration of nerve block and postoperative analgesia. Postoperative analgesia consisted of 100 mg IV ketoprofen every 8 hours with the first administration at request.

RESULTS: The onset time of sciatic nerve block was 15 (5-60) min with levobupivacaine, 30 (5-60) min with bupivacaine, and 15 (5-60) min with ropivacaine (P = NS). No differences in the quality of nerve block as well as in the nerve block resolution times were observed among the three groups. The duration of postoperative analgesia was 16 (8-24) hours with levobupivacaine, 14 (8-24) hours with bupivacaine, and 17 (8-24) hours with ropivacaine (P=NS).

CONCLUSIONS: Using 0,5% levobupivacaine for sciatic nerve block results in similar clinical effects as those produced by using the same volume and concentration of either bupivacaine or ropivacaine.