Comparison of the % 0,5 levobupivacaine and % 0,5 bupivacaine on qt dispersion and haemodynamics effects on epidural anaesthesia

Comparison of the % 0,5 Levobupivacaine and % 0,5 Bupivacaine on QT dispersion and haemodynamics effects on epidural anaesthesiaAIM: Aim of the study is to compare 0.5% bupivacaine and its homolog 0.5% levobupivacaine in operations performed under epidural anesthesia. We applied same dose and volume of bupivacaine and levobupivacaine and compared their effects on the hemodynamic variables, QT dispersion and their side-effects.MATERIAL-METHOD: Sixty patients having surgery under epidural anesthesia with ASA I-II the age range was between 20 and 60 were included to the study. After monitorization and initial ECG, epidural catheter was inserted. After patients were given a test dose of 3ml of 2% bupivacaine (60mg); 15ml of 0.5% bupivacaine was given to Group B patients (n=30) and 15ml of 0.5% levobupivacaine was given to Group L patients (n=30). After 30 minutes, ECG was taken. Sensorial blockade level was assessed with pinprick test, motor blockade with Bromage Scale. After sensorial blockade reached to the level of T10, operation started. In operation, SKB, DKB, OKB, KAH, SpO2 measurement, respiratory rate and side-effects were recorded. Postoperatively, motor blockade recovery time was assessed at 30-minute intervals to record total motor blockade time. 24-hour postoperatively, 3? th ECG was taken.RESULTS: There were no statistically significant differences between the groups concerning the age, length, weight, sex, ASA scale, KAH, SpO2 measurements, respiratory rate; and SKB, DKB, OKB levels upto the 150 minutes; after 180 minutes, the differences were significant. The total sensorial blockade time was significantly longer in Group B when compared with Group L. Two-segment recovery time, reaching time of the blockade upto the level of T10 were similar. Motor blockade was more commonly detected in Group B.Among the side-effect, arrythmia, dyspnea and agitation were not detected in both groups; bradycardia, nausea, vomitting and tremor were detected in both groups. Hypotension was more common in Group B. In ECG, there was no significant difference between groups regarding heart rate, the longest QT interval, the shortest QT interval and corrected QT dispersion time. But there were significant differences between groups regarding the longest corrected QT interval and the shortest corrected QT interval.CONCLUSION: Levobupivacaine is a local anesthesic agent that can be a good alternative to bupivacaine in patient who has cardiac problem and when less motor blockade is desired.Keywords: Bupivacaine, Levobupivacaine, ECG, QT dispersion