Efficacy and Safety of Levobupivacaine:a Multicenter SurveyNORA(NewRegional Anaesthetic)
Horáček M.1, Michálek P.2, Mach D.3, Miloschewsky D. za účastníky průzkumu NORA
1KAR FN v Motole a IPVZ, Praha 2Úsek kardiovaskulární anestezie a intenzivní péče ARO Nemocnice Na Homolce, Praha 3ARO Nemocnice Nové Město na Moravě |
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Summary:
Objective: To investigate the efficacy and safety of levobupivacaine, a new local anaesthetic associated with a low frequency
of toxicity in an everyday clinical practice.
Design: Open-label prospective questionnaire survey.
Setting: Departments of anaesthesiology in 57 hospitals in the Czech Republic.
Material and Methods: 3325 patients aged 2–97 years operated in regional or combined anaesthesia with levobupivacaine
or with an obstetric analgesia between May and December 2003. Participating anaesthesiologists filled data in data
collection sheets. Reported data were centrally loaded into the NORA database and processed. The efficacy of levobupivacaine
was evaluated by the quality of a sensory and the intensity of a motor blockade, the safety of levobupivacaine by
untoward side effects, the need to stop further administration of the drug, the frequency of technical problems was also
noted.
Results: The levobupivacaine administration (mostly 0,5%) resulted in an excellent or satisfactory quality of the sensory
anaesthesia in 97.3% of cases, the degree of a motor block relied on the type of block used, the spinal anaesthesia produced
the complete motor block in 73.9% of cases, while a single-shot epidural anaesthesia produced most frequently a moderate
motor block and the continuous epidural anaesthesia affected the motor function in a minimal way only. Untoward side
effects, mainly hypotension and bradycardia, occurred in 200 patients (6%), most frequently in a single-shot epidural
anaesthesia (7.4%), less in spinal anaesthesia (6.7%) rarely in peripheral nerve blocks on the extremities. The levobupivacaine
administration had to be stopped in 5 patients (0.15%).
Conclusion: Levobupivacaine is an effective and safe drug for both central and peripheral nerve blocks in everyday clinical
practice.
Key words:
local anaesthesia – local anaesthetics – levobupivacaine – efficacy – safety
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