Levobupivacaine – a Safer Variant of 30-year-old Subject

Overview

Levobupivacaine is a long acting, amide-type local anaesthetic and is the S(-)-enantiomer of racemic bupivacaine. Themajority of in vitro, in vivo and human pharmacodynamic studies indicate that levobupivacaine has a similar potency tobupivacaine in various types of nerve blocks. However, levobupivacaine has a lower risk of cardiovascular and CNS toxicitythan bupivacaine. Randomised, double blind clinical studies established that the anaesthetic and/or analgesic effects oflevobupivacaine were very similar to those of bupivacaine of thesame dose.The sensory block tended to be a little bit longerwith levobupivacaine than bupivacaine. Levobupivacaine was generally as effective as bupivacaine for regional anaesthesiafor various types of surgery, for pain management during labour, and for postoperative pain management, especially whencombined with opioids, or clonidine. The tolerance profiles of levobupivacaine and bupivacaine were very similar. The mostcommon adverse event associated with levobupivacaine administration was hypotension. Excluding pharmacoeconomicconsiderations, levobupivacaine is an appropriate choice for use in place of bupivacaine.

Key words:
bupivacaine – levobupivacaine – ropivacaine – local anaesthetics – cardiotoxicity – CNS toxicity