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REGIONAL ANESTHESIA

Vasoconstriction and Analgesic Efficacy of Locally Infiltrated Levobupivacaine for Nasal Surgery

Yavuz Demiraran, MD^*, Ozcan Ozturk, MD, Ender Guclu, MD, Abdulkadir Iskender, MD^*, Mehmet Hakan Ergin, MD^*, and Abdurahman Tokmak, MD

From the Departments of *Anesthesiology, and Otorhinolaryngology, University of Duzce, Duzce Faculty of Medicine, Duzce, Turkey.

Address correspondence and reprint requests to Yavuz Demiraran, MD, Department of Anesthesiology, Faculty of Medicine, University of Duzce, Duzce, Turkey. Address e-mail to demiryvz{at}yahoo.com.

BACKGROUND: In this study, we compared the use of preincisional lidocaine 2% with epinephrine (LA) and levobupivacaine 0.25% plain (LB) for postoperative analgesia and vasoconstriction in patients undergoing nasal surgery.

METHODS: Sixty patients were randomly assigned to receive preincisional local infiltration under general anesthesia. Group LB received levobupivacaine 0.25%, and group LA received epinephrine plus lidocaine 2% (add volume injected). Intraoperative hemodynamic changes, pre- and postoperative hemoglobin and hematocrit values were recorded. Visual analog scale values 30 min and 1, 2, 8, 12, and 24 h postoperatively and the need for rescue analgesic treatment in the first 24 h of all patients was recorded.

RESULTS: At 30 min and 1, 2, 8, and 12 h postoperatively, visual analog scale values were lower in group LB than in group LA (P < 0.0001, P = 0.002, P = 0.023, P < 0.0001, and P = 0.011, respectively). The analgesic requirement was significantly lower in group LB when compared with that in group LA (P = 0.038). Group LB had significant differences between preoperative and postoperative hemoglobin and hematocrit values (P = 0.014 and 0.025). Group LA had significant differences between preoperative and postoperative hemoglobin and hematocrit values (P = 0.031 and 0.024).

CONCLUSIONS: We conclude that postoperative analgesia in nasal surgery with local infiltration of levobupivacaine was significantly more potent and longer lasting than that achieved by lidocaine plus epinephrine.