Article Text

Download PDFPDF
A Comparison of Levobupivacaine 0.5% and Racemic Bupivacaine 0.5% for Extradural Anesthesia for Caesarean Section
  1. Kathryne A. Faccenda, F.R.C.A.,
  2. Alison M. Simpson, F.R.C.A.,
  3. Duncan J. Henderson, F.R.C.A.,
  4. Drew Smith, F.R.C.A.,
  5. Elizabeth M. McGrady, F.R.C.A. and
  6. Lachlan M.M. Morrison, F.F.A.R.S.C.I.
  1. From the Department of Anaesthesia, St. John's Hospital, Livingston, West Lothian, Scotland; and Department of Anaesthesia, Glasgow Royal Maternity Hospital, Glasgow, Scotland
  1. Reprint requests: Dr. Kathryne A. Faccenda, F.R.C.A., Department of Anaesthesiology and Pain Medicine, University of Alberta Hospital, 8440-112 St., Edmonton, Alberta, Canada, T6G 2B7. E-mail: faccenda{at}


Background and Objectives: Bupivacaine is available as a racemic mixture of its enantiomers, dextrobupivacaine and levobupivacaine. Both in vitro and in vivo studies show that dextrobupivacaine has a greater inherent central nervous system (CNS) and cardiovascular toxicity than levobupivacaine. Clinical studies show levobupivacaine to have similar local anesthetic potency to the racemate. The aim of this study was to investigate the clinical efficacy and safety of levobupivacaine compared with racemic bupivacaine for extradural anesthesia.

Methods: We studied 62 patients undergoing elective caesarean delivery who received 25 mL of either levobupivacaine 0.5% or bupivacaine 0.5%, extradurally, in a randomized, double-blind study.

Results: The 2 groups were similar in terms of time to block suitable for surgery, segmental spread, and duration of sensory block. However, lower-limb motor block was significantly longer in the levobupivacaine group but of significantly less intensity.

Conclusions: Levobupivacaine produces an extradural block that is similar to bupivacaine, and is a suitable local anesthetic agent for caesarean delivery.

  • Regional anesthesia
  • Extradural
  • Local anesthetics
  • Levobupivacaine
  • Obstetrics
  • Caesarean delivery

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • K.A.F. and A.M.S. both received a research Fellowship from Chiroscience UK Ltd.

    Presented in part at the XVII Annual Congress of the European Society of Regional Anaesthesia, Geneva, Switzerland, 1998.