Efficacy and Safety of Levobupivacaine:a Multicenter SurveyNORA(NewRegional Anaesthetic)

Overview

Objective:
To investigate the efficacy and safety of levobupivacaine, a new local anaesthetic associated with a low frequencyof toxicity in an everyday clinical practice.Design: Open-label prospective questionnaire survey.Setting: Departments of anaesthesiology in 57 hospitals in the Czech Republic.Material and Methods: 3325 patients aged 2–97 years operated in regional or combined anaesthesia with levobupivacaineor with an obstetric analgesia between May and December 2003. Participating anaesthesiologists filled data in datacollection sheets. Reported data were centrally loaded into the NORA database and processed. The efficacy of levobupivacainewas evaluated by the quality of a sensory and the intensity of a motor blockade, the safety of levobupivacaine byuntoward side effects, the need to stop further administration of the drug, the frequency of technical problems was alsonoted.Results: The levobupivacaine administration (mostly 0,5%) resulted in an excellent or satisfactory quality of the sensoryanaesthesia in 97.3% of cases, the degree of a motor block relied on the type of block used, the spinal anaesthesia producedthe complete motor block in 73.9% of cases, while a single-shot epidural anaesthesia produced most frequently a moderatemotor block and the continuous epidural anaesthesia affected the motor function in a minimal way only. Untoward sideeffects, mainly hypotension and bradycardia, occurred in 200 patients (6%), most frequently in a single-shot epiduralanaesthesia (7.4%), less in spinal anaesthesia (6.7%) rarely in peripheral nerve blocks on the extremities. The levobupivacaineadministration had to be stopped in 5 patients (0.15%).Conclusion: Levobupivacaine is an effective and safe drug for both central and peripheral nerve blocks in everyday clinicalpractice.

Key words:
local anaesthesia – local anaesthetics – levobupivacaine – efficacy – safety