Levobupivacaine, most recentlevoisomer of bupivacaine with lesser cardio-neurotoxicity, is now increasingly being used in spinal anaesthesia, however its use in hysterectomy is not much studied. We evaluated clinical characteristics of isobaric levobupivacaine in spinal anaesthesia for abdominal and vaginal hysterectomy.70 patients undergoing abdominal hysterectomy (n=35) and vaginal hysterectomy (n=35) in spinal anaesthesia received 20 mg (0.5%, 4 ml) of isobaric levobupivacaine in L2-L3 interspace. Data regarding sensory-motor block (onset, extent, duration), hemodynamics, clinical efficacy in terms of anaesthetic supplementation and adverse effects were recorded.Sensory onset in terms of time to T10 was 5.56±1.80 min. and time to T6 was 10.71±2.76 min. Median value of peak sensory level was T6(T10-T4). All patients achieved maximum bromage score of 3 (complete motor block) in 5.45±1.469 min. (motor onset). Incidence of hypotension was 42.82% (n=30/70) and bradycardia was 7.14% (n=5/70), which occurred as a single episode and were easily treated with mepentermine and atropine respectively. Spinal anaesthesia was considered completely successful (no supplementation) in 100% (n=35/35) cases of vaginal hysterectomy and 91.42% (n=32/35) cases of abdominal hysterectomy. Only 8.57% (n=3/35) cases of abdominal hysterectomy required intraoperative anaesthetic supplementation (ketamine). None of the cases was converted to general anaesthesia (failure rate=0%). We conclude that 20 mg of isobaric levobupivacaine in spinal anaesthesia produced effective sensory-motor block with stable hemodynamic profile for abdominal and vaginal hysterectomy. Owing to greater safety profile it could be a reasonable option in the arena of spinal anaesthesia.
