BSTRACT : Bupivacaine was the first long acting amino-amide local anaesthetic agent being used and levobupivacaine is the pure (S-isomer) enantiomer of bupivacaine. levobupivacaine produces differential neural blockade with less motor blockade, cardiovascular and neurological toxicity makes it suitable for day care surgery.

Aim: To evaluate the efficacy and safety of Isobaric levobupivacaine 0.5% when compared to hyperbaric bupivacaine0.5% with fentanyl 25mcg in lower limb surgeries

METHODS : The study was randomized and double blinded, conducted in 60 adult patients scheduled for lower limb surgery using spinal anaeshthesia. Anaesthtic agent used were Inj Isobaric levobupivacain 0.5% (2.5ml) & Inj Fentanyl 25microgm (group LF) in 30 patients and Inj hyperbaric Bupivacaine 0.5% (2.5ml)& Inj Fentanyl(25microgm)( group BF) in other 30 patients.

RESULTS : Median duration of sensory block at the T10 dermatome was significantly longer in BF group.The median duration of complete motor block (modified bromage scale 3) was significantly shorter in the LF group

CONCLUSIONS : Levobupivacaine with Fentanyl found to be better combination with less complication with high success rate. Intrathecal levobupivacaine with fentanyl provided satisfactory anaesthesia with haemodynamic stability for major lower limb orthopaedic surgery. It provided similar sensory but shorter duration of motor block compared to bupivacaine with fentanyl which is a desirable feature for early ambulation, voiding and physiotherapy.