Comparison of Characteristics of Mixed Versus Sequential Administration of Levobupivacaine and Fentanyl in Subarachnoid Block for Lower Limb Surgeries: A Randomized Control Study

Dr. Shameer Imam, Dr. Harsh Vardhan

Abstract: Aim: To evaluate differences in characteristic of subarachnoid block administered by giving levobupivacaine and fentanyl as a mixture or individually in a varying sequence for lower limb surgeries. Methods: From January 2021 to June 2022 a prospective randomized single blind controlled study on a total of 120adult patients allocated into three groups of 40 patients each according to computer generated random numbers before the commencement of study. Group A patients will receive mixed 0.5% isobaric levobupivacaine 3 ml (15 mg) and 0.5 ml (25 microgram) of fentanyl in a single 5.0 ml syringe. Group B patients will receive 0.5 ml (25 microgram) of fentanyl in a 3.0 ml syringe followed by 3 ml of 0.5% isobaric levobupivacaine in a 5 ml syringe and Group C will receive 3ml of 0.5% isobaric levobupivacaine in a 5ml syringe followed by 0.5 ml (25 microgram) of fentanyl in a 3 ml syringe. Result: Sequential administration levobupivacaine followed by fentanyl resulted in a faster onset of both sensory and motor blocks, a shorter time to achieve the highest sensory level, and a more prolonged time until the need for the first rescue analgesia with a comparable adverse effects profile. Conclusion: Administering levobupivacaine first followed by fentanyl i.e., sequentially leads to an early onset and prolonged duration of sensory and motor block.

Keywords: Levobupivacaine, Fentanyl, Subarachanoid Block