Comparison of efficacy and safety of isobaric levobupivacaine with hyperbaric bupivacaine for exploratory appendicectomy under subarachnoid block with dexmedetomidine as sedative agent “an observational study”

Background: Appendectomy in past was performed under general anaesthesia, in recent years there has been growing emphasis on the role of regional anaesthesia especially spinal anaesthesia. Bupivacaine is available in isobaric and hyperbaric forms for intrathecal use with addition of opoids to modify their effects. Methods: Patients were divided into two groups. Group I recieved spinal anaesthesia with 3ml of 0.5% isobaric levobupivacaine plus 20mcg of fentanyl and group II with 3ml of 0.5% hyberbaric bupivacaine plus 20mcg of fentanyl and i.v dexmedetomidine started in both groups. Quality of anaesthesia, sensory and motor blockade characteristics, haemodynamics, sedation score and side effects were compared. Results: The quality of anaesthesia was compared in both groups. The mean onset of sensory and motor block was faster and duration was significantly longer in group II. Side effects and haemodynamics were better in group I and side effects were comparable. Conclusion: Both isobaric levobupivacaine and hyberbaric bupivacaine provide adequate spinal block. Levobupivacaine enables quicker recovery and better haemodynamic stability as compared with hyberbaric bupivacaine, while later is better for prolonged surgeries.