BACKGROUND: Levobupivacaine is the isolated S-enantiomer of bupivacaine and may be a favorable alternative to bupivacaine. The author evaluated the clinical efficacy of levobupivacaine relative to bupivacaine in spinal anesthesia.

METHODS: The author randomly allocated 40 ASA physical status I or II patients undergoing lower limb surgery to do unilateral spinal anesthesia with 8% glucose bupivacaine 4 mg (n = 20) or 8% glucose levobupivacaine 4 mg (n = 20). Spinal anesthesia was performed at the L3-4 interspace using a 25-gauge Whitacre spinal needle. The lateral decubitus position was maintained for fifteen minutes after injection.

RESULTS: Thirty minutes after injection, unilateral sensory block was present in 60% and 40% of cases, and unilateral motor block was observed in 90% and 85% in levobupivacaine and bupivacaine group, respectively. Levobupivacaine group had no differences as compared to bupivacaine group for spinal block resolution.

CONCLUSIONS: It was concluded that 8% glucose levobupivacaine 4 mg and 8% glucose bupivacaine 4 mg provided similar spinal block for lower limb surgery without hemodynamic unstability.