Levobupivacaine S (-) and Ropivacaine are the two enantiomers of Bupivacaine newly introduced in to clinical practice in India with claims of less cardiotoxicity and safety. Hence there is a need to study the clinical efficacy and safety of intrathecal isobaric levobupivacaine and ropivacaine in lower limb orthopaedic surgeries.

After institutional ethical clearance and informed written consent 60 patients posted for elective lower limb orthopaedic surgeries in Krishna Rajendra Hospital Mysore were randomnly assigned to 2 groups of n=30 each to receive intrathecal isobaric levobupivacaine 0.5% 3 ml (15 mg) (L group) and isobaric ropivacaine 0.5% 3 ml (15 mg) (R group). Sensory and motor blockade onset, dermatomal level, duration of sensory and motor blockade, hemodynamic parameters, need for vasopressors, adverse effects were recorded and compared. Results were analysed for statistical significance (P) using Student t test and ANOVA.

We found no significant difference in the onset of sensory and motor blockade, dematomal level of analgesia between 2 groups. The duration of sensory and motor blockade was significantly higher in L group (P value <0.05). Hemodynamic changes were minimal in both the groups.

Intrathecal 0.5% levobupivacaine as well as 0.5% ropivacaine are effective in lower limb orthopaedic surgeries. Duration of sensory and motor blockade is more with 0.5% levobupivacaine.