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Revista Brasileira de Anestesiologia

On-line version ISSN 1806-907X


TANAKA, Pedro Paulo; SOUZA, Ronie Oliveira de; SALVALAGGIO, Matheus Felipe de Oliveira  and  TANAKA, Maria Aparecida de Almeida. Comparative study of 0.5% bupivacaine versus 0.5% bupivacaine enantiomeric mixture (S75-R25) in epidural anesthesia for orthopedic surgery. Rev. Bras. Anestesiol. [online]. 2003, vol.53, n.3, pp. 331-337. ISSN 1806-907X.

BACKGROUND AND OBJECTIVES: With the objective of finding a safer drug than racemic bupivacaine, several animal studies were performed with its enantiomers. This study aimed at evaluating the efficacy of 0.5% bupivacaine enantiomeric mixture (S75-R25) as compared to 0.5% bupivacaine in lumbar epidural anesthesia for lower limb orthopedic surgery. METHODS: Participated in this randomized double-blind study 38 adult patients, aged 17 to 69 years, physical status ASA I and II submitted to lower limb orthopedic surgery, who were distributed in two groups: Group B - 30 ml of 0.5% bupivacaine and Group BEM - 30 ml of 0.5% bupivacaine enantiomeric mixture (S75-R25). Sensory and motor block characteristics were investigated, in addition to the incidence of side effects. RESULTS: There have been significant weight differences in group BEM. Hemodynamic parameters were similar in both groups. There were no differences in time to reach Bromage score and peak block height. Also time to total motor block regression was similar between groups. There has been a significant difference in Bromage 2 score between groups, which was higher in group BEM. CONCLUSIONS: Adequate sensory and motor block for surgery was achieved in both groups with few side effects, suggesting that both solutions are safe in lumbar epidural anesthesia for orthopedic surgery.

Keywords : ANESTHETICS [Local]; ANESTHETICS [bupivacaine]; ANESTHETICS [enantiomeric mixture of bupivacaine]; ANESTHETIC TECHNIQUES [Regional]; ANESTHETIC TECHNIQUES [epidural].

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