scholarly journals Comparison of effect of intrathecal dexmedetomidine and clonidine as an adjuvant to hyperbaric bupivacaine in patients undergoing surgery for fracture femur and tibia

2017 ◽  
Vol 4 (12) ◽  
pp. 3833
Author(s):  
G. Praveen Chandra ◽  
Sampathi Shiva Krishna ◽  
Pooja Singh
Keyword(s):  
Motor Block ◽  
Elective Surgery ◽  
Onset Time ◽  
Hyperbaric Bupivacaine ◽  
Wound Infiltration ◽  
Nerve Blocks ◽  
Rescue Analgesia ◽  
Fracture Femur ◽  
Significant Difference ◽  
Group D

Background: Spinal anaesthesia with bupivacaine is administered routinely for lower abdominal and lower limb surgeries. The ensuing nerve block is sufficient to ensure patient’s wellbeing, while motor block facilitates the surgeon’s work. Post-operative pain relief can be achieved by various methods namely systemic opioid and non-opioid peripheral nerve blocks and local wound infiltration, each with their own merits and demerits. the present study was undertaken to compare the effect of intrathecal dexmedetomidine and clonidine as an adjuvant to hyperbaric bupivacaine in patients undergoing surgery for fracture femur and tibia.Methods: 80 patients between 20-60 years, undergoing elective surgery for closed fracture shaft of femur and tibia with ASA physical status of 1 and 2 were included in the study. All the subjects were randomly allocated to one of the two groups (Group C and Group D) by a computer-generated randomization chart. Group C received 2.5ml of 0.5% hyperbaric bupivacaine with 50mcg clonidine and group D received 2.5ml of 0.5% hyperbaric bupivacaine with 5mcg dexmedetomidine.Results: 30 of the 40 patients in group C were of ASA I and 10 were ASA II, while in group D, 25 were ASA I and 15 were ASA II. A significant difference was found in the onset time for sensory and motor block, receding time for sensory and motor block and the need of the first rescue analgesia between the two groups, showing that Dexmedetomidine was more potent than clonidine.Conclusions: Dexmedetomidine is a potent, highly selective and specific α2-adrenoreceptor agonist that has both sedative and analgesic effects and is also a valuable adjuvant when regional anaesthesia is incorporated.

scholarly journals A COMPARATIVE STUDY OF INTRATHECAL BUPIVACAINEHEAVY (0.5%) WITH BUPIVACAINE HEAVY (0.5%) PLUS DEXMEDETOMIDINE FOR LOWER ABDOMINAL SURGERIES

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Kumar Shailesh ◽  
Jitendra Prasad Singh ◽  
Arjun Prasad ◽  
Veena Horo
Keyword(s):  
Side Effects ◽  
Normal Saline ◽  
Motor Block ◽  
Onset Time ◽  
Local Anaesthetics ◽  
Control Group ◽  
Hyperbaric Bupivacaine ◽  
Rescue Analgesia ◽  
High Doses ◽  
Group D

Introduction: Several adjuncts like adrenaline, opioids and alpha-2 adrenergic agonists are being used with local anaesthetics intrathecally for prolongation of intra-operative and post-operative analgesia and to reduce the side-effects of high doses of local anaesthetics. Aim: The present study was done to evaluate the onset and duration of sensory and motor block, hemodynamic effects, post-operative analgesia and adverse effects of Dexmedetomidine given intrathecally with hyperbaric 0.5% Bupivacaine. Materials and methods: Sixty inpatients of ASA class I and II scheduled for various lower abdominal surgeries under Sub-Arachnoid Block were randomly divided into two groups of 30 each namely C (Control), D(Dexmedetomidine) . All received 12.5mg hyperbaric bupivacaine plus 0.5 ml Normal Saline in Group C (Control),10µg Dexmedetomidine (diluted in preservative free Normal saline of 0.5ml) in Group D(Dexmedetomidine) . The onset time to reach peak sensory and motor level, the regression time for sensory and motor block, hemodynamic changes and side-effects were noted. Results: The duration of sensory and motor block, rescue analgesia was significantly prolonged in Dexmedetomidine group when compared to that of Control group. Conclusion: Dexmedetomidine 10 µg seems to be a better neuraxial adjuvant to hyperbaric Bupivacaine. Keywords: Bupivacaine; Dexmedetomidine; intrathecal.

scholarly journals COMPARISON OF CLONIDINE AND DEXMEDETOMIDINE AS AN ADJUVANT TO 0.5% BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK: A RANDOMISED PROSPECTIVE DOUBLE-BLIND STUDY

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Kushal Jethani ◽  
Preeti Sahu ◽  
Seethal Ann
Keyword(s):  
Brachial Plexus ◽  
Motor Block ◽  
Brachial Plexus Block ◽  
Double Blind Study ◽  
Nerve Blocks ◽  
Rescue Analgesia ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block ◽  
Group D

Background and Objectives: Alpha-2 agonists are used as adjuvant with local anaesthetic agents to prolong the duration of spinal, epidural and peripheral nerve blocks as well as to prolong the duration of post operative analgesia. We performed a study to compare clonidine(1ug/kg) and dexmedetomidine (1ug/kg) as an adjuvant to 0.5% bupivacaine in supraclavicular brachial plexus block. Methods: Eighty ASA I and II patients scheduled for elective upper limb orthopaedic surgeries under supraclavicular brachial plexus block were divided into two  groups(n=25 each) in a randomized, double-blinded fashion. Group C received clonidine 1 μg/kg and Group D received dexmedetomidine 1 μg/kg added to bupivacaine 0.5% (30 cc). Onset and recovery time of sensory and motor block, as well as duration of analgesia were studied in both the groups. Results: Duration of sensory block and motor block was 220.12 ±50.3 and 280.1± 20.12 min respectively in group C, while it was 410.34± 60.12 and 460.4 ± 50.56 min respectively in group D and hence both were significantly prolonged in group D.  No statistically significant difference was seen in onset of sensory and motor block between the two groups. The duration of analgesia i.e. time to requirement of rescue analgesia was 270.4± 56.7 mins and 452.7 ±64.23 mins in group C and D respectively and  this difference was statistically significant (P=0.001). Conclusion: Addition of dexmedetomidine to bupivacaine 0.5% in supraclavicular brachial plexus block prolonged the duration of sensory and motor block as well as the duration of analgesia when compared with clonidine. Keywords: Clonidine, dexmedetomidine, supraclavicular block

scholarly journals A comparative study of the effect of intrathecal tramadol and buprenorphine used as adjuvants to hyperbaric bupivacaine for postoperative analgesia in infraumbilical surgeries

2019 ◽  
pp. 263-267
Author(s):  
Sana Siddiq ◽  
Naila Asad ◽  
Abaid -ur- Rehman ◽  
Maqsood Ali ◽  
Hafiz M Usman Khalid ◽  
...  
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Comparative Study ◽  
Postoperative Analgesia ◽  
Motor Block ◽  
Onset Time ◽  
Hyperbaric Bupivacaine ◽  
Rescue Analgesia ◽  
Significant Difference ◽  
Group B

Background & Objective: The augmentation of local anesthetics with various adjuvants to enhance the quality and efficacy of subarachnoid block is clinically in practice since long. Comparative studies on effects of adding intrathecal tramadol and buprenorphine has never been studied before. Both drygs are esily available in our country. So, we conducted this study to evaluate and compare the characteristics of subarachnoid blockade, duration of postoperative analgesia, dose of recue analgesic postoperatively, and adverse effects of intrathecal buprenorphine (50 μg) and intrathecal tramadol (30 mg) as adjuvants to 0.5% hyperbaric bupivacaine for lower abdominal surgeries Methodology: This prospective randomized, single blind controlled trial was carried out at Services Hospital Lahore, from January to July 2018. 110 American society of Anesthesiologist I - II male patients, 35 to 45 y of age undergoing subarachnoid block for infra-umbilical surgery were randomized into two groups. Group T (n = 55) patients received 10 mg of 0.5% bupivacaine and 30 mg of tramadol intrathecally, while group B (n = 55) received 10 mg 0.5% bupivacaine with 50 μg of buprenorphine. Sensory testing was done by pin prick method using 25G blunt needle and time taken to reach T10 level noted. Motor block was assessed using Modified Bromage Scale. The time taken to reach modified Bromage 3 was recorded. Side effects and postoperative analgesia noted for 24 h by VAS score every 20 min for first 2 h in PACU and then 4 hourly for 24 h in the ward. Patients with inadequate block were converted into general anesthesia and were excluded from the study. Time to first rescue analgesia, and total analgesic required in 24 h were compared in two groups.Results: Mean VAS scores were less in Group T as compared to Group B. Significant difference was seen among groups at 45 min (p = 0.04), 60 min (p = 0.02), 75 min (p = 0.03), 90 min (p = 0.01), 120 min (p = 0.00), 4h (p = 0.007), 8 h (p = 0.01), 12 h (p = 0.01), 16 h (p = 0.00). After 24 h no significant difference was seen in both groups. Mean onset time for sensory block was earlier in Group B (2.4 min) compared to Group T (2.7 min)(p = 0.001). Mean onset time for motor block was earlier in Group B (4.8 min)as compared to Group T (5.5 min)(p = 0.00). No significant difference was seen among groups in side effects (p > 0.05). Mean time for rescue analgesia in Group B was earlier (4.51 ± 2.8 h.) as compared to Group T (4.94 ± 4.1h). Total dose of analgesic given in 24 h was significantly less in group T. (p = 0.004) The mean dose given in Group B (1.24 ± 0.96 mg/kg) was greater than Group T (0.76 ± 0.71 mg/kg)Conclusion: We conclude that both tramadol and buprenorphine, prolong the duration of postop analgesia without adding any adverse effects, but duration with tramadol is longer; it significantly reduces VAS and the dose of analgesic requirement in 24 h postoperatively.IRB letter No. IRB/2018/427/SIMS Citation: Siddiq S, Asad N, Rehman AU, Ali M, Khalid HMU, Butt Z. A comparative study of the effect of intrathecal tramadol and buprenorphine used as adjuvants to hyperbaric bupivacaine for postoperative analgesia in infraumbilical surgeries. Anesth pain & intensiv care 2019;23(3):263-267

scholarly journals A comparison of intrathecal 0.5% hyperbaric ropivacaine with 0.5% hyperbaric bupivacaine for elective surgery: a prospective, randomized, double-blind, controlled study

2021 ◽  
Vol 9 (2) ◽  
pp. 471
Author(s):  
Pallavi Amol Kharat ◽  
Rajshree Chandrashekhar Deopujari
Keyword(s):  
Lower Limb ◽  
Motor Block ◽  
Elective Surgery ◽  
Sensory Block ◽  
Controlled Study ◽  
Complete Regression ◽  
Hyperbaric Bupivacaine ◽  
Duration Of Action ◽  
Significant Difference ◽  
Group B

Background: To compare the onset of action, intensity and duration of motor block of 0.5% hyperbaric ropivacaine with 0.5% hyperbaric bupivacaine for elective lower abdominal, perineal and lower-limb surgeries.Methods: 70 patients undergoing elective lower abdominal, perineal and lower limb surgery receiving spinal anesthesia were divided randomly into two groups, Group B, (bupivacaine 5 mg/ml with glucose 80 mg/ml;4 ml, and Group R, (ropivacaine 5 mg/ml with glucose 80 mg/ml; 4 ml).Results: The results were analyzed and compared using Chi-square test, student ‘s t-test and Fisher’s exact tests. The onset of sensory block was more rapid with bupivacaine (p<0.05). The maximum cephalad spread was similar in both groups. However, the time required to maximum extent of cephalic spread was less in Group B (p<0.05). Motor block 3 according to modified bromage scale was obtained in both groups and the time to achieve the same was not significant. The duration of motor blockade i.e., time to complete regression of motor block was significantly greater with Group B than with Group R (0.0001). We found that there was no significant difference in the time taken to achieve grade 3 motor block but ropivacaine gave a lesser degree of motor block which regressed faster than bupivacaine (118 min versus 156 min; p<0.0001). There was no significant difference in hemodynamic parameters except that diastolic and mean pressures remained on lower side in group B (p<0.05).Conclusions: We conclude that 0.5% hyperbaric ropivacaine provides a sensory block of similar onset and extent, shorter duration of action and less frequency of hypotension as compared to 0.5% hyperbaric bupivacaine.

scholarly journals A Comparative Study of Oral Dexmedetomidine versus Oral Midazolam As preanesthesia Medication in Pediatric Patients to Reduce anxiety

2019 ◽  
Vol 4 (2) ◽  
pp. 724-728
Author(s):  
Sabin Gauchan ◽  
Chitra Thapa ◽  
Abha Prasai
Keyword(s):  
General Anesthesia ◽  
Separation Anxiety ◽  
Elective Surgery ◽  
Sedation Score ◽  
Preoperative Anxiety ◽  
Parental Separation ◽  
Emergence Agitation ◽  
Oral Midazolam ◽  
Significant Difference ◽  
Group D

Introduction: Preoperative period is a stressful period. In children the preoperative anxiety is expressed as difficult separation from parents and difficult mask induction. The level of preoperative anxiety also affects postoperative outcomes. To overcome anxiety premedication is often used by pediatric anesthesiologist. Objective: The objective of this study was to compare the effect of oral midazolam 0.5mg/kg and oral dexmedetomidine 4μg/kg on parental separation, mask induction and postoperative emergence agitation in children undergoing elective surgery under general anesthesia. Methodology: 120 children aged 2-8years undergoing elective surgery under general anesthesia were divided into two groups: Group M and Group D. Patients in group M received oral midazolam 0.5mg/kg and patients in group D received oral dexmedetomidine 4μg/kg. After 45min of premedication sedation score was assessed in both the groups. Ease of parental separation and mask acceptance was compared in both the groups. In the postoperative period occurrence of emergence agitation was compared in both the groups. Results: There was no statistically significant difference in preoperative sedation score in both the groups. Parent separation anxiety score and mask acceptance score were statistically similar in both the groups. But emergence agitation was significantly lesser in patients who received dexmedetomidine premedication. Conclusions: Premedication with oral midazolam as well as oral dexmedetomidine effectively reduces parental separation anxiety and produces satisfactory mask induction in pediatric age group. However, dexmedetomidine is more effective in reducing emergence delirium in comparison to midazolam.

scholarly journals COMPARISON OF FENTANYL AND DEXMEDETOMIDINE AS AN ADJUVANT TO BUPIVACAINE IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK: A RANDOMIZED-DOUBLE BLIND PROSPECTIVE STUDY

2016 ◽  
Vol 9 (5) ◽  
pp. 74 ◽  
Author(s):  
Daisy Karan ◽  
Swastika Swaro ◽  
Swarna Banerjee
Keyword(s):  
Brachial Plexus ◽  
Upper Limb ◽  
Brachial Plexus Block ◽  
Nerve Blocks ◽  
Double Blind ◽  
Rescue Analgesia ◽  
Sensory Blockade ◽  
Significant Difference ◽  
Supraclavicular Brachial Plexus Block ◽  
Plexus Block

ABSTRACTObjectives: Supraclavicular block of brachial plexus provides complete and reliable anesthesia for upper limb surgeries. Using adjuvant to localanesthetics, blocks can be prolonged to long durations. Peripheral nerve blocks thus help in avoiding the hazards of general anesthesia. We comparedthe sensory blockade, motor blockade, and duration of analgesia with the addition of fentanyl or dexmedetomidine to bupivacaine for supraclavicularbrachial plexus block.Methods: A total of 50 American Society of Anesthesiologist’s Physical Status I and II patients scheduled for elective upper limb surgeries undersupraclavicular brachial plexus block were divided into two equal groups in a randomized double-blinded fashion. Group BF received 30 mlbupivacaine with fentanyl 50 µg and Group BD received 30 ml bupivacaine with dexmedetomidine 50 µg. The characteristics for anesthesia andanalgesia were assessed in both groups.Results: Duration of sensory and motor block was 363.4±38.36 minutes and 357±36.77 minutes, respectively, in Group BF while it was452.96±77.12 minutes and 441.52±48.46 minutes in Group BD. There was a statistically significant difference in onset of sensory and motorblock between the two groups. The duration of analgesia (time to requirement of rescue analgesia) in Group BD was longer than in Group BF(471.44±65.88 minutes vs. 366.48±38.02 minutes) with (p<0.0001). There were minimum hemodynamic disturbances and side effects in any groupexcept for Grade 3 sedation score which was more in Group BD.Conclusion: Dexmedetomidine, when added to bupivacaine in supraclavicular brachial plexus block, enhanced the duration of sensory and motorblock and also the duration of analgesia, more than when fentanyl was added to bupivacaine.Keywords: Fentanyl, Dexmedetomidine, Bupivacaine, Supraclavicular brachial block.

scholarly journals EFFICACY OF USG GUIDED FASCIA ILIACA COMPARTMENT BLOCK AS POSTOPERATIVE ANALGESIA IN PROXIMAL FRACTURE FEMUR

2020 ◽  
pp. 10-13
Author(s):  
Kulkarni Sanhita J. ◽  
Sahasrabuddhe Saumil S ◽  
Joshi Pradnya S ◽  
Bhale Pramod V ◽  
Sasturkar Vasanti M ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Femur Fracture ◽  
Proximal Femur Fracture ◽  
P Value ◽  
Ultrasound Guided ◽  
Total Consumption ◽  
Rescue Analgesia ◽  
Fracture Femur ◽  
Significant Difference

Background Fascia iliaca compartment nerve block (FICNB) has been reported to provide effective postoperative analgesia in patients with femur fracture. This study aimed to evaluate the effectiveness of FICNB with Bupivacaine and Dexamethasone for postoperative analgesia in proximal fracture femur. Methods Sixty-four patients of ASA grade 1 to 3, aged 50-80 years scheduled for proximal femur fracture femur were included and randomly assigned to two groups of 32 patients each Group F received ultrasound guided(FICNB) with 0.25% 40ml of Bupivacaine & Dexamethasone 4 mg & Group T received Tramadol 50mg at the end of surgery. Postoperative pain was assessed at 30 minutes, 2 hours, 4 hours, 6 hours, 8 hours, 12 hours and 24 hours using visual analogue scale (VAS). Injection Paracetamol 1gm was given intravenously as rescue analgesia in both the groups when VAS was more than four. Results Both the groups were comparable for demographic parameters. The mean duration of analgesia was 460.31±10.50 minutes in the FICNB group while it was only 263.72±12.85 minutes in the tramadol group, the difference being statistically significant (with a ‘p value’ of 0.001). The total consumption of paracetamol did not show a significant difference in either of the groups in the first 24 hours, the ‘p value’ being 0.406. Conclusion Ultrasound guided FICNB given postoperatively in patients undergoing proximal fracture femur can provide postoperative pain relief for longer duration than Inj. Tramadol.

scholarly journals A COMPARATIVE STUDY OF CLONIDINE VERSUS NALBUPHINE AS INTRATHECAL ADJUVANTS TO 0.5% HYPERBARIC BUPIVACAINE DURING LOWER ABDOMINAL SURGERIES – A RANDOMIZED DOUBLE BLIND INTERVENTIONAL STUDY.

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Trishala Jain ◽  
Jaipal .
Keyword(s):  
Motor Block ◽  
Sensory Block ◽  
Double Blind Study ◽  
Hyperbaric Bupivacaine ◽  
Double Blind ◽  
Rescue Analgesia ◽  
Institutional Ethics ◽  
Group A ◽  
Group B ◽  
Intrathecal Clonidine

Background: Regional anesthesia techniques for gynecological procedures are on increasing trends due to their advantage of postoperative analgesia owing to intrathecal adjuvants. The present study was aimed to comparatively evaluate the clinical efficacy of clonidine with nalbuphine when co-administered intrathecally with 0.5% hyperbaric bupivacaine for Lower abdominal surgeries in Gynecology. Methods: With institutional ethics committee clearance No. 193MC/EC/2018, randomized, double blind study was conducted. After obtaining informed written consent total of 84 patients scheduled for lower abdominal surgeries were randomly allocated into two groups: Group A (n=42) - Inj.  3.5 ml Bupivacaine 0.5% + 0.2 ml Clonidine(30µg) intrathecally.  Group B (n=42) - Inj.3.5 ml Bupivacaine 0.5%+0.2 ml Nalbuphine(2mg) intrathecally. The characteristics of sensory and motor block, hemodynamic data, side effects were recorded. Results: The onset of sensory block was earlier in Group B than Group A (3.08±0.52 min vs 4.00±0.54 min, p<0.001 ). The onset of motor block was also earlier in Group B than Group A (7.78±0.80 min vs 8.80±0.95min, p<0.001). The time to first rescue analgesia in patients receiving intrathecal clonidine was significantly delayed than patients receiving intrathecal nalbuphine (284.95 ± 12.93 min vs 211.52 ± 15.92 min, p<0.001). Introperative hemodynamic changes were comparable and none of the patient suffered from respiratory depression except very little cases of shivering which are not significant. Conclusions: Intrathecal clonidine as adjuvant to bupivacaine provided was clinically more effective than nalbuphine for prolonging the duration of analgesia for gynecological procedures. Keywords: Bupivacaine, Clonidine, Lower abdominal surgeries in gynecology, Nalbuphine, Subarachnoid block.

scholarly journals Effects of Granisetron on Spinal Anesthesia-induced Hypotension

2021 ◽  
Author(s):  
Cem Koray Çataroğlu ◽  
Alp Alptekin ◽  
Aysel Gezer ◽  
Murat Sayın ◽  
Aslı Dönmez
Keyword(s):  
Heart Rate ◽  
Sodium Chloride ◽  
Spinal Anesthesia ◽  
Chloride Solution ◽  
Sodium Chloride Solution ◽  
Elective Surgery ◽  
Demographic Data ◽  
Hyperbaric Bupivacaine ◽  
Significant Difference ◽  
Isotonic Sodium Chloride

Objective: It was aimed to evaluate the effect of intravenous (IV) granisetron used for nausea and vomiting prophylaxis on hypotension and bradycardia caused by spinal anesthesia. Methods: 120 ASA 1-2 patients undergoing elective surgery under spinal anesthesia were randomly divided into Group G (Ganisetron; n=60) and Group P (Placebo; n=60) groups. Five minutes before spinal anesthesia, Group G received 1 mg intravenous granisetron diluted in 10 mL of isotonic sodium chloride solution and Group P received 10 mL of isotonic sodium chloride solution. Spinal anesthesia with hyperbaric bupivacaine 0.5%, 15 mg at the level of L4-5 was applied for both groups. Hemodynamic data, sensory and motor block parameters were recorded before and after spinal anaesthesia every 5 minutes during 20 minutes of surgery. Results: There was no difference in the demographic data of both groups. Although hemodynamic data showed a decrease in both groups according to initial values, blood pressure measurements in group G were significantly higher than the first measure values. There was no significant difference in heart rate values between the groups. Conclusion: Intravenous granisetron reduces hypotension after spinal anesthesia, but it has no significant effect on heart rate.

scholarly journals Comparison between isobaric levobupivacaine 0.5% and hyperbaric bupivacaine 0.5% in spinal anesthesia in lower limb surgeries and lower abdominal surgeries in adult patients

2021 ◽  
Vol 9 (2) ◽  
pp. 418
Author(s):  
Preeti Parashar ◽  
Anisha Singh ◽  
Manoj Kumar Sharma ◽  
Dipak L. Raval
Keyword(s):  
Blood Pressure ◽  
Lower Limb ◽  
Motor Block ◽  
Total Duration ◽  
Sensory Block ◽  
Hyperbaric Bupivacaine ◽  
Significant Difference ◽  
The Mean ◽  
Group B ◽  
Mean Time

 Background: The aim of our study was to compare sensory and motor block characteristics and hemodynamic changes following intrathecal hyperbaric bupivacaine (0.5%) and isobaric levobupivacaine (0.5%) in elective lower limb and lower abdominal surgeries.Methods: 60 patients of either sex, aged 18-60 years, ASA grade I or II scheduled for elective lower abdominal and lower limb surgeries were randomized into two groups, group B (n=30) and group L (n=30) and received either 3 ml of intrathecal hyperbaric bupivacaine or isobaric levobupivacaine intrathecally.Results: The mean time of onset of sensory block at shin of tibia in both the groups was comparable i.e. levobupivacaine (1.19±0.2 minutes) and bupivacaine (1.1+0.2 minutes). The mean time for total duration of sensory block was 211.1±8.2 minutes in group L, while 193.13±13.7 minutes in group B. Time for total duration of motor block in group L was 198.76±8.428 minutes and in group B was 182.6±13.989 minutes. Statistically significant difference was observed in total duration of sensory and motor block in both levobupivaciane and bupivacaine group (p<0.0001). Patients in group L were hemodynamically more stable with significantly less decrease in pulse rate, systolic blood pressure and diastolic blood pressure as compared to group B.Conclusions: We observed that 0.5% isobaric levobupivacaine provided better hemodynamic stability, longer duration of sensory and motor block as compared to bupivacaine. 

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