• Andrea Casati, Jacques E Chelly, Elisa Cerchierini, Roberta Santorsola, Fiorella Nobili, Crispino Grispigni, Pia Di Benedetto, and Giorgio Torri.
• Vita-Salute University, Department of Anesthesiology, IRCCS H. San Raffaele, Milan, Italy. casati.andrea@hsr.it
• J Clin Anesth. 2002 Mar 1;14(2):111-4.

Study ObjectiveTo compare the intraoperative and postoperative clinical properties of the sciatic nerve block performed with either 0.5% bupivacaine or 0.5% levobupivacaine for orthopedic foot procedures.DesignRandomized, double-blind study.SettingInpatient unit of a university-affiliated hospital.Patients30 ASA physical status I and II patients undergoing elective hallux valgus repair under regional anesthesia.InterventionsAfter administering intravenous (IV) midazolam premedication (0.05 mg/kg), a femoral nerve block was performed with 15 mL of mepivacaine 2%. Patients were then randomly allocated to receive, in a double-blind fashion, a sciatic nerve block with 20 mL of either 0.5% bupivacaine (n = 15) or 0.5% levobupivacaine (n = 15).Measurements And Main ResultsAn observer who was blinded to the study drug recorded the onset time, quality, and duration of the sciatic nerve block. Postoperative analgesia consisted of 100 mg IV ketoprofen every 8 hours, with the first administration given at the patient's request. Mean (+/-SEM) onset time of the sciatic nerve block was 35 +/- 5 minutes for bupivacaine and 31 +/- 6 minutes for levobupivacaine (p = not significant [NS]). The duration of motor and sensory blocks with bupivacaine was 761 +/- 112 minutes and 790 +/- 110 minutes, respectively, and 716 +/- 80 minutes and 814 +/- 73 minutes, respectively, with levobupivacaine (p = NS). The first pain medication was requested after 844 +/- 96 minutes with bupivacaine and 872 +/- 75 minutes after levobupivacaine (p = NS). No differences in the quality of nerve block and patient satisfaction were reported between the two groups.ConclusionsA dose of 20 mL of 0.5% levobupivacaine induces sciatic nerve block of similar onset, duration, and intensity as the block produced by the same volume and concentration of the racemic solution of bupivacaine.

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