A comparison of epidural local anesthetics administered for thoracic surgery: Bupivacaine versus levobupivacaine

Aim: we aimed to compare the analgesic efficacy,hemodynamia,and side effects of epidural bupivacaine and levobupivacaine given preoperative,intraoperative,and postoperative periods of thoracic surgery. materials and methods: thirty adult patients undergoing elective thoracotomy were divided into two groups receiving thoracal epidural bupivacaine or levobupivacaine. group i received bupivacaine,whereas group ii received levobupivacaine boluses both 15 min before surgical incision and during the closure of thorax. continuous epidural infusion of fentanyl combined with either bupivacaine or levobupivacaine was given in intensive care unit. in addition,all patients received iv morphine bolus with patient controlled analgesia device. if shoulder pain persisted,diclofenac sodium was administered. hemodynamic data,pain scores,and side effects were recorded from preoperative period to 24th hr of epidural infusion. results: the difference in mean arterial pressures,heart rates,pain scores,and morphine consumptions were not significant between the groups (p > 0.05). decrease in visual analog scale was statistically significant compared to the basal values within the groups during the postoperative period (p < 0.05). there were no serious side effects. conclusion: bupivacaine and levobupivacaine were found to be comparable in the analgesia,hemodynamia,and side effects for thoracic surgery. in combination with thoracic epidural fentanyl,a continuous infusion of levobupivacaine may be considered as a good alternative to bupivacaine.