Update on local anesthetics: focus on levobupivacaine

@article{Burlacu2008UpdateOL,
  title={Update on local anesthetics: focus on levobupivacaine},
  author={Crina L. Burlacu and Donal J Buggy},
  journal={Therapeutics and Clinical Risk Management},
  year={2008},
  volume={4},
  pages={381 - 392}
}
In recent years levobupivacaine, the pure S (−)-enantiomer of bupivacaine, emerged as a safer alternative for regional anesthesia than its racemic parent. It demonstrated less affinity and strength of depressant effects onto myocardial and central nervous vital centers in pharmacodynamic studies, and a superior pharmacokinetic profile. Clinically, levobupivacaine is well tolerated in a variety of regional anesthesia techniques both after bolus administration and continuous postoperative… Expand
Does levobupivacaine have a benefit over bupivacaine in our practice?
TLDR
Clinically, the onset time of sensory block, time to T 10 sensory block and time to complete motor block are lower with bupivacaine than with levobupavacaine, and it offers advantages over bupvacaine. Expand
Clinical Pharmacokinetics and Pharmacodynamics of Levobupivacaine
TLDR
Clinical trials of relative potency are impaired by the variability in chosen endpoints for sensory and motor function blockade, but clinically significant differences in potency are minor, with most clinical trials showing similar duration and quality of anaesthesia between levo- and racemic bupivacaine. Expand
Estudio comparativo de la bupivacaína versus levobupivacaína a nivel intradural : valoración anestésica y neuro-oftalmológica
TLDR
Preliminary clinical experience shows equal efficacy for both local anesthetics, and the main differences were that bupivacaina produced a spinal block which showed time to maximum motor block and sensory and motor block onset faster than levobupivacaine, as well as present mean maximum level of sensory block higher. Expand
A COMPARATIVE EVALUATION OF DEXMEDETOMIDINE AND CLONIDINE AS ADJUVANTS TO LEVOBUPIVACAINE IN EPIDURAL ANAESTHESIA FOR LOWER LIMB ORTHOPAEDIC SURGERIES
BACKGROUND: There are always efforts to find a better and safer local anaesthetic along with adjuvants in epidural anaesthesia. Bupivacaine is a long acting, effective local anaesthetic that isExpand
Comparative evaluation of clinical efficacy of intrathecal isobaric levobupivacaine and isobaric bupivacaine in patients undergoing infra-umbilical surgery
TLDR
The present study indicated that levobupivacaine is a valid alternative to racemic bupvacaine for spinal anesthesia, which has similar clinical profile, requirement of rescue analgesic and side effect such as hemodynamic changes, nausea and vomiting. Expand
Effect of Addition of Dexmedetomidine as an Adjuvant to Levobupivacaine in Supraclavicular Brachial Plexus Block
TLDR
The primary outcome of the study was the duration of analgesia, and the secondary outcome were duration and onset of sensory and motor block and side effects. Expand
The effects of Different Concentrations and Equivalent Volumes of Levobupivacaine in Epidural Anesthesia.
TLDR
This study indicated that 10 mL of 0.5% levobupivacaine plus 5 mL of0.9% saline is a suitable solution for use in epidural anesthesia because it produces a block clinically comparable to that of 10 mL. Expand
The comparative study of epidural levobupivacaine and bupivacaine in major abdominal surgeries
TLDR
The results of this study suggest that same concentration of epidural levobupivacaine and bupvacaine with fentanyl provide stable postoperative analgesia and both were found safe for the patients undergoing major abdominal surgery. Expand
Ketamine and levobupivacaine versus levobupivacaine alone for post operative analgesia and side effects in lower abdominal surgeries in children – A comparative study
Background: Different additive drugs such as opioids, epinephrine, clonidine, and neostigmine have been used along with local anaesthetics to improve the duration and quality of analgesia. FewExpand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 128 REFERENCES
Levobupivacaine Versus Racemic Bupivacaine for Spinal Anesthesia
TLDR
It is concluded that intrathecal levobupvacaine is equal in efficacy to, but less toxic than, racemic bupivacaine. Expand
Hyperbaric Spinal Levobupivacaine: A Comparison to Racemic Bupivacaine in Volunteers
TLDR
Hyperbaric spinal levobupivacaine has equivalent clinical efficacy to racemic bupvacaine for spinal anesthesia in doses from 4 to 12 mg. Expand
Levobupivacaine versus racemic bupivacaine for spinal anaesthesia in orthopaedic major surgery.
TLDR
Comparisons of clinical and anaesthetic features of levobupivacaine and racemic bupivacane when intrathecally administered in 60 patients undergoing major orthopaedic surgical procedures found the former remaining a cheap and effective local anaesthetic yet, and the latter a valid alternative for spinal anaesthesia. Expand
Pharmacokinetics of Levobupivacaine, Fentanyl, and Clonidine After Administration in Thoracic Paravertebral Analgesia
TLDR
After paravertebral bolus and infusion administration, Cpmax levobupivacaine was within the safe range and fentanyl and clonidine were less than the effective levels after IV administration, suggesting that their analgesic effect may be partly attributed to a peripheral mechanism of action. Expand
Levobupivacaine and fentanyl for spinal anaesthesia: a randomized trial
TLDR
This prospective, randomized, double‐blind study compared the clinical efficacy, motor block and haemodynamic effects of using 2.5% levobupivacaine with fentanyl 15 μg for spinal anaesthesia in urological surgery and concluded that 2.3 mL of 0.5%, as effective as 2.4%, is as effective. Expand
Epidural Levobupivacaine 0.1% or Ropivacaine 0.1% Combined with Morphine Provides Comparable Analgesia After Abdominal Surgery
TLDR
It is concluded that when used as patient-controlled epidural analgesia and combined with small-dose epidural morphine, 0.1% levobupivacaine and 0. Expand
A Comparison of Levobupivacaine 0.125%, Fentanyl 4 μg/mL, or Their Combination for Patient-Controlled Epidural Analgesia After Major Orthopedic Surgery
TLDR
It is concluded that the analgesic effects of levobupivacaine 0.125% and fentanyl are additive and beneficial for the management of orthopedic surgical pain by the PCEA method. Expand
A comparison of levobupivacaine 0.125%, fentanyl 4 microg/mL, or their combination for patient-controlled epidural analgesia after major orthopedic surgery.
TLDR
It is concluded that the analgesic effects of levobupivacaine 0.125% and fentanyl are additive and beneficial for the management of orthopedic surgical pain by the PCEA method. Expand
A Comparison of Epidural Levobupivacaine 0.75% with Racemic Bupivacaine for Lower Abdominal Surgery
TLDR
Both local anesthetics are well tolerated and effective in producing epidural anesthesia for patients undergoing lower abdominal surgery and their effects were clinically indistinguishable. Expand
Levobupivacaine versus Racemic Bupivacaine in Spinal Anaesthesia for Urological Surgery
TLDR
It is concluded that 0.5% levobupivacaine can be used as an alternative to 0. Expand
...
1
2
3
4
5
...