Spinal anesthesia for transurethral resection operations: bupivacaine versus levobupivacaine.

BACKGROUND: This study tested the hypothesis that 0.5% levobupivacaine might be a good alternative to 0.5% plain bupivacaine for local spinal anesthesia during transurethral resection (TUR) operations.

METHODS: A prospective, randomized, double-blinded study was conducted on 50 male ASA I-III patients aged >60 years who were scheduled for elective transurethral resection operations. After routine monitoring, spinal anesthesia was performed with patients in the left lateral position using a 25G Quincke needle in the L3-4 interspace with a midline approach. Group B (N.=25) received 2.5 mL of 0.5% plain bupivacaine and Group L (N.=25) received 2.5 mL of 0.5% levobupivacaine via intratechal injection. The characteristics of sensory and motor block, hemodynamic data, side effects, and patient and surgeon satisfaction were recorded. Patients were observed until the level of sensory block was S1 and the Bromage score was 0.

RESULTS: There were no significant differences between the two groups for patient demographic data, American Society of Anesthesiologists (ASA) classification, type and duration of operation, side effects, and patient and surgeon satisfaction. Hemodynamic parameters were similar in both groups before and during the operation. The highest level of sensory block was T(7)(T(3)-T(10)) in Group B and T9(T4-T12) in Group L (P=0.001).

CONCLUSION: Administration of 0.5% levobupivacaine may be a good alternative to 0.5% plain bupivacaine for local spinal anesthesia during TUR operations.