<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.2d1 20170631//EN" "JATS-journalpublishing1.dtd">
<ArticleSet>
  <Article>
    <Journal>
      <PublisherName>jmedicalcasereports</PublisherName>
      <JournalTitle>Frontiers in Medical Case Reports</JournalTitle>
      <PISSN>I</PISSN>
      <EISSN>S</EISSN>
      <Volume-Issue>Volume 5; Issue 5</Volume-Issue>
      <PartNumber/>
      <IssueTopic>Multidisciplinary</IssueTopic>
      <IssueLanguage>English</IssueLanguage>
      <Season>(Sep-Oct, 2024)</Season>
      <SpecialIssue>N</SpecialIssue>
      <SupplementaryIssue>N</SupplementaryIssue>
      <IssueOA>Y</IssueOA>
      <PubDate>
        <Year>-0001</Year>
        <Month>11</Month>
        <Day>30</Day>
      </PubDate>
      <ArticleType>Medical Case Reports</ArticleType>
      <ArticleTitle>Efficacy of Levobupivacaine in Regional Anaesthesia - A Narrative Review</ArticleTitle>
      <SubTitle/>
      <ArticleLanguage>English</ArticleLanguage>
      <ArticleOA>Y</ArticleOA>
      <FirstPage>1</FirstPage>
      <LastPage>12</LastPage>
      <AuthorList>
        <Author>
          <FirstName>Jagan</FirstName>
          <LastName>G</LastName>
          <AuthorLanguage>English</AuthorLanguage>
          <Affiliation/>
          <CorrespondingAuthor>N</CorrespondingAuthor>
          <ORCID/>
          <FirstName>Priyadharshini</FirstName>
          <LastName>P</LastName>
          <AuthorLanguage>English</AuthorLanguage>
          <Affiliation/>
          <CorrespondingAuthor>Y</CorrespondingAuthor>
          <ORCID/>
          <FirstName>Divya</FirstName>
          <LastName>S</LastName>
          <AuthorLanguage>English</AuthorLanguage>
          <Affiliation/>
          <CorrespondingAuthor>Y</CorrespondingAuthor>
          <ORCID/>
          <FirstName>Dhinesh Kumar</FirstName>
          <LastName>C</LastName>
          <AuthorLanguage>English</AuthorLanguage>
          <Affiliation/>
          <CorrespondingAuthor>Y</CorrespondingAuthor>
          <ORCID/>
          <FirstName>Krishna Prasad</FirstName>
          <LastName>T</LastName>
          <AuthorLanguage>English</AuthorLanguage>
          <Affiliation/>
          <CorrespondingAuthor>Y</CorrespondingAuthor>
          <ORCID/>
        </Author>
      </AuthorList>
      <DOI/>
      <Abstract>Background: The pursuit of safer and more effective anesthetic agents continues to be a key focus in anesthesiology. Levobupivacaine, a purified derivative of bupivacaine, has emerged as a preferable alternative for regional anesthesia due to its enhanced safety profile. Clinical studies have shown that levobupivacaine provides similar efficacy to bupivacaine but with a more favorable pharmacokinetic profile. It has been well-tolerated in various regional anesthesia techniques, including bolus administration and continuous postoperative infusion, with few adverse drug reactions, typically linked to incorrect administration or pharmacological effects. Allergic reactions are rare. Comparative studies indicate that levobupivacaine and bupivacaine offer comparable surgical sensory blocks, adverse effects, and labour analgesia outcomes, with similar safety profiles for both maternal and fetal health.&#13;
&#13;
Objectives: This review aims to examine the pharmacokinetic and pharmacological benefits of levobupivacaine, highlighting its safety and clinical applications based on current evidence.&#13;
&#13;
Results: Levobupivacaine is generally more powerful than ropivacaine but less strong than bupivacaine, according to the majority of clinical investigations. A total of 60 studies were discovered. Some studies, such as those with unavailable full-text publications, were eliminated. Finally, 26 publications were chosen and studied since they were relevant to the current review aims. Sushma examined, in 60 patients receiving axillary block utilizing the nerve stimulation technique, the effects of 30 ml of 1.5% lidocaine with adrenaline compared to 30 ml of 0.333% levobupivacaine. Agarwal compared the effectiveness of bupivacaine and levobupivacaine in 56 patients receiving supraclavicular brachial plexus block. Levobupivacaine, according to the study, caused both motor and sensory blocks to start more quickly.&#13;
&#13;
Conclusion: Levobupivacaine is a long-acting local anesthetic that closely resembles bupivacaine in its clinical effects, but it offers specific advantages such as reduced cardiotoxicity.</Abstract>
      <AbstractLanguage>English</AbstractLanguage>
      <Keywords>Levobupivacaine,Regional Anaesthesia,Local Anaesthetics</Keywords>
      <URLs>
        <Abstract>https://jmedicalcasereports.org/ubijournal-v1copy/journals/abstract.php?article_id=15400&amp;title=Efficacy of Levobupivacaine in Regional Anaesthesia - A Narrative Review</Abstract>
      </URLs>
      <References>
        <ReferencesarticleTitle>References</ReferencesarticleTitle>
        <ReferencesfirstPage>16</ReferencesfirstPage>
        <ReferenceslastPage>19</ReferenceslastPage>
        <References>Agarwal P, Singh B. Comparative evaluation of Bupivacaine and Levobupivacaine in Supraclavicular brachial plexus block. Journal of Advanced Medical and Dental Sciences Research 2019; 7: 201-203.&#13;
&#13;
Attri JP, Makhni R, Sethi S. Levobupivacaine for labor analgesia. Anesth Essays Res 2016; 10: 493-496.&#13;
&#13;
Bajwa SJ, Kaur J. Clinical profile of levobupivacaine in regional anesthesia: A systematic review. J Anaesthesiol Clin Pharmacol 2013; 29: 530-539.&#13;
&#13;
Brajkovic D, Brkovic B, Milic M, Biocanin V, Krsljak E, Stojic D. Levobupivacaine vs. bupivacaine for third molar surgery: quality of anaesthesia, postoperative analgesia and local vascular effects. Clin Oral Investig 2014; 18: 1481-1488.&#13;
&#13;
De Negri P, Ivani G, Tirri T, Modano P, Reato C, Eksborg S, Lonnqvist PA. A comparison of epidural bupivacaine, levobupivacaine, and ropivacaine on postoperative analgesia and motor blockade. Anesth Analg 2004; 99: 45-48.&#13;
&#13;
Frawley G, Smith KR, Ingelmo P. Relative potencies of bupivacaine, levobupivacaine, and ropivacaine for neonatal spinal anaesthesia. Br J Anaesth 2009; 103: 731-738.&#13;
&#13;
Glaser C, Marhofer P, Zimpfer G, Heinz MT, Sitzwohl C, Kapral S, Schindler I. Levobupivacaine versus racemic bupivacaine for spinal anesthesia. Anesth Analg 2002; 94: 194-198,&#13;
&#13;
Gulec D, Karsli B, Ertugrul F, Bigat Z, Kayacan N. Intrathecal bupivacaine or levobupivacaine: which should be used for elderly patients? J Int Med Res 2014; 42(2):376-85.&#13;
&#13;
Guler G, Cakir G, Ulgey A, Ugur F, Bicer C, Gunes I, Boyaci A. A comparison of spinal anesthesia with levobupivacaine and hyperbaric bupivacaine for cesarean sections: A randomized trial. Open Journal of Anesthesiology 2012; 2: 84-89&#13;
&#13;
Jadhav PA, Malde AD. Comparison of levobupivacaine 0.25% and bupivacaine 0.25% for caudal analgesia in children undergoing herniotomy. Pediatric Anesthesia and; Critical Care Journal (PACCJ) 2017; 5(2).&#13;
&#13;
Kalsotra S, Chowadhary J, Dogra S, Gulati S. Comparison of the Effects of Epidural 0.5% Bupivacaine and 0.5% Levobupivacaine Administration Without Adjuvant Medication on Anaesthasia Quality, Side Effect Incidence and Analgesia Requirement Times in in Electively Operated Cases on Hip and Lower Extremity. JK Science 2017; 19: 53-58.&#13;
&#13;
Kopacz DJ, Allen HW, Thompson GE. A comparison of epidural levobupivacaine 0.75% with racemic bupivacaine for lower abdominal surgery. Anesth Analg 2000; 90: 642-648.&#13;
&#13;
Kothari R, Fernandes S, Atkar A, Paliwal S. A prospective observational study to compare the effectiveness of bupivacaine versus levobupivacaine in supraclavicular brachial plexus block. International Journal of Contemporary Medical Research 2020; 7: I1-16&#13;
&#13;
Kothari R, Fernandes S, Atkar A, Paliwal S. A prospective observational study to compare the effectiveness of bupivacaine versus levobupivacaine in supraclavicular brachial plexus block. International Journal of Contemporary Medical Research 2020; 7: I1-16.&#13;
&#13;
Mathur V, Verma AK, Khare A, Garg DK, Thada B, Singh M. A prospective randomized study to compare intrathecal isobaric levobupivacaine with or without fentanyl in various infraumbilical surgeries. In The Indian Anaesthetists Forum 2022; 23: 98-104.&#13;
&#13;
Moin SA, Devulapalli PK, Ahmed DS. A Prospective Randomized Double Blind comparative study of Epidural Anesthesia with Bupivacaine (0.5%) 15ml and Levobupivacaine (0.5%) 15ml in Patients undergoing Elective Lower Abdominal Surgery. International Journal of Latest Trends in Engineering and Technology 2013; 2: 1-10.&#13;
&#13;
Pham Dang C, Langlois C, Lambert C, Nguyen JM, Asehnoune K, Lejus C. 0.5% levobupivacaine versus 0.5% ropivacaine: Are they different in ultrasound-guided sciatic block? Saudi J Anaesth 2015; 9: 3-8.&#13;
&#13;
Rangapriya A, Venkatraman R, Karthik M, Preethi A. A Comparison of the Effects of Epidural Levobupivacaine and Morphine for Postoperative Analgesia Following Major Abdominal Surgery: A Randomized Controlled Trial. Cureus 2023; 15: e34900.&#13;
&#13;
Sahin AS, Tand;uuml;rker G, Bekar A, Bilgin H, Korfali G. A comparison of spinal anesthesia characteristics following intrathecal bupivacaine or levobupivacaine in lumbar disc surgery. Eur Spine J 2014 Mar;23(3):695-700.&#13;
&#13;
Sanford M, Keating GM. Levobupivacaine: a review of its use in regional anaesthesia and pain management. Drugs 2010; 70: 761-791.&#13;
&#13;
Sushma DR, Srinivas VY, NK JG. A clinical study of effects of 30 ml of 1.5% lidocaine with adrenaline and 30 ml of 0.333% levobupivacaine for axillary block using nerve stimulation technique. Indian Journal of Clinical Anaesthesia 2020; 7: 77-82.&#13;
&#13;
Tavoletti D, Rosanand;ograve; E, CE PL. Combined femoral and sciatic nerve block with Levobupivacaine in Brugada syndrome patient: a case report. Journal of Anaesthesia and Critical Care Case Reports 2020; 6: 19-21.&#13;
&#13;
Thalamati D, Sambandam KG, Kodali V RK, Karthekeyan RB, Vakamudi M. Comparison of Ropivacaine and Levobupivacaine in Supraclavicular Brachial Plexus Blocks-A Double Blinded Randomized Control Study. Turk J Anaesthesiol Reanim 2021; 49: 278-283.&#13;
&#13;
Thammaiah SH, Sreenath RH, Swamy AHM, Kumararadhya GB, Priya SS. Comparison between intermittent epidural bolus of levobupivacaine 0.125% and ropivacaine 0.2% with fentanyl as adjuvant for combined spinal epidural technique in labor analgesia: A double blinded prospective study. Ann Afr Med 2023; 22: 88-93.&#13;
&#13;
Uzuner A, Saracoglu KT, Saracoglu A, Erdemli O. The comparative study of epidural levobupivacaine and bupivacaine in major abdominal surgeries. J Res Med Sci 2011; 16: 1159-1167.&#13;
&#13;
Vanna O, Chumsang L, Thongmee S. Levobupivacaine and bupivacaine in spinal anesthesia for transurethral endoscopic surgery. J Med Assoc Thai 2006; 89: 1133-1139.</References>
      </References>
    </Journal>
  </Article>
</ArticleSet>