Estudo comparativo entre levobupivacaína a 0,5% e bupivacaína racêmica a 0,5% associadas ao sufentanil na anestesia peridural para cesariana

摘要

BACKGROUND AND OBJECTIVES: Although the widespread use of local anesthetics in surgery and obstetrics, racemic bupivacaine is associated to potentially fatal cardiotoxicity. Data suggest that levobupivacaine has local anesthetic effects similar to racemic bupivacaine with the advantage of less central nervous system and cardiovascular toxicity. Studies have shown that epidural anesthesia with racemic bupivacaine and sufentanil for cesarean sections results in a better quality of anesthesia. This study aimed at comparing the efficacy of 0.5% racemic bupivacaine and 0.5% levobupivacaine, both associated to sufentanil, for epidural anesthesia in parturients undergoing cesarean delivery. METHODS: Participated in this double-blind study 52 obstetric patients submitted to elective cesarean delivery under epidural anesthesia. Patients were randomized to receive 27 ml of 0.5% levobupivacaine and 30 μg sufentanil (Group I n=26) or 27 ml of 0.5% bupivacaine and 30 μg sufentanil (Group II n=26). Characteristics of sensory and motor block, time for analgesics request in the postoperative period and the incidence of side effects were investigated. RESULTS: Sensory and motor block, time for analgesics request and adverse effects did not differ between groups. However, motor block was significantly longer with levobupivacaine as compared to racemic bupivacaine (p < 0.05). CONCLUSIONS: Although a longer motor block duration with 0.5% epidural levobupivacaine associated to sufentanil, the efficacy of both local anesthetics associated to sufentanil for cesarean delivery was similar.