Comparision of clinical maternal and fetal effects of levobupivacaine and bupivakaine for spinal anesthesia undergoing caserian surgery

Aim: For caserian section, regional anesthesia is preferenced a technique to general anesthesia because of maternal and fetal high morbidity and mortality. Complications of regional anesthesia tecniques are rarely high sensorial blockage or local anesthesic toxicity. Bupivacaine has a lot of advantages for this purpose but cardiotoxisity disturbs its clinic profile. Cardiotoxicity is important for the development of quick hypoxia during pregnancy and difficulties in cardiogenik resusstation. In caserian sexio operations we aimed to compare maternal and fetal effects of intratecal bupivacaine and levobupivacaine which was the enantiomer of bupivacaine and offered for using in recent years.Materials and Methods: Forty, ASAI-II, volunteers, between 20 and 40 years old and 36-41 gestational weeks undergoing elective caserian sectio operation were enrolled in our study. Patients who were morbid obesity, who had preeclampsy, diabetes mellitus, enfection in enjection area, contrindications to spinal anesthesia and allergies to drugs that would be used were not enrolled in the study. Standart monitorization was performed to all patients and sistolic, diastolic and mean arteryal pressure; heart rate, peripheral oxygen saturation were recorded by deterimined intervals. 10ml/kg Ringer Lactate were administered to prevent hypotension before spinal anesthesia to all patients and ephedrine was used when hypotension occured. %0.5 Levobupivacaine 10mg and %0.5 bupivacaine 10 mg was applied with 22-26 gauge spinal needle by lateral decubit position with randomise method. Blocage levels were recorded from the onset of the spinal to 180 minutes within intervals; motor blockage was assessed using Bromage scales, sensorial changes were assessed by pinprick sensation and sympathetic blockage were assessed by cotton with alcohol. In addition, complications (hypotension, nausea-vomiting, bradycardia, convulsions, urine retention, post spinal headache) that could exist, and APGAR values of neonate at first and fifth minutes and umbilical cord blood gases were recorded. The data were as assessed with T-test, Chi-Square, Fisher Exact, Mann-Whitney U test.Results: At the end of the study in bupivacaine group decrease of heart rate, hypotension and peripheral oxygen saturation were detected and longer duration of sensorial blockage, slower sempatic blockage and less motor blockage were noted in levobupivacaine group.Conclusion: We have shown that in spinal anesthesia undergoing caserian section, levobupivacaine was less toxic than bupivacaine group and more potent anestesic and had no effects unwished for neonates.