Levobupivacaine has been introduced into clinical practice
within the last few years. It has been used at all sites: epidural,
subarachnoid, different levels of brachial plexus block –
interscalene, supra and infraclavicular, intercostal and peripheral
nerve blockade, peribulbar and retrobulbar blockade, local
infiltration, obstetric analgesia, postoperative pain management,
acute and chronic pain management. The doses used are very
similar to those of bupivacaine. As a result of its lower cardiac and
neurotoxicity compared to racemic bupivacaine, anaesthetists feel
safer working with levobupivacaine, than with bupivacaine
Levobupivacaine is a relatively new long acting local anaesthetic,
with a pharmacological activity very similar to that of racemic
bupivacaine. The first studies in humans confirm the animal
studies and the in vitro studies, which showed that this new
molecule is less cardiotoxic and less neurotoxic than the racemic
bupivacaine. Levobupivacaine can be used for all indications in
which the anaesthetist needs a long acting local anaesthetic. The
reduced toxicity of this new local anaesthetic is an advantage for
the patient. The cost in Colombia is 40% higher, than racemic
bupivacain
.
