Comparative Evaluation of Levo-Bupivacaine against Ropivacaine for Post-Operative Pain Relief in Patients of Laparoscopic Appendectomy

Abstract

Introduction: Pain in the immediate postoperative period is less after laparoscopic surgery  than conventional  surgical techniques. Ropivacaine is often in favored over Bupivacaine to avoid toxicity. Levo-bupivacaine a newer version of bupivacaine is said to be safer than Ropivacaine. We have evaluated the pain relief provided by Ropivacaine and Levo-bupivacaine instilled intra-abdominally during laparoscopic surgery for acute appendicitis. Methods and material: In a randomized placebo controlled study conducted on 90 patients in private medical institute over a period of year, a  patient control analgesia (PCA) total amount of morphine utilized to attain pain scores of 0-1 was measured in placebo, Ropivacaine and Levo-bupivacanie group  using visual analog score (VAS). Data was analyzed using analysis of variance and tests of statistical significance were employed.    Results:  Significant difference was not observed between the Ropivacaine and Levo-bupivacaine groups with similar utilization of morphine for both drugs. Whereas significant difference was noted between placebo and local anaesthetics.  Conclusions: There appear to be no difference between Ropivacaine and Levo-bupivacaine in terms of pain relief. Pre-emptive instillation of local anaesthetic for laparoscopic surgery is beneficial for post-operative pain relief.