الفهرس | Only 14 pages are availabe for public view |
Abstract Summary Every day, clinical practice for regional anesthesia confirms its security and value for perioperative pain control. All patients with femoral fractures are optimal candidates for 3-in-1 FNBs. The FNB is especially helpful in patients with significant opiate tolerance, opiate allergy and patients with comorbidities Inconsistent block success and procedure related complications have been reduced with the introduction of ultrasound in regional anesthesia practice. Levobupivacaine the S-enantiomer of racemic bupivacaine is less cardiotoxic whereas showing similar local-anesthetic properties and the potency of racemic bupivacaine. The aim of the present study was to compare between levobupivacaine and plain bupivacaine in ultrasound guided three in one femoral nerve in patient undergoing unilateral lower limb surgery. Sixty patients of both sex of ASA physical status I and II scheduled for unilateral lower limb surgery under three in one FNB included in our study. group I (levo – group): Includes 30 patients received 0.25% plain bupivacaine at 0.5 ml/Kg as the three in one FNB. group II (bupi- group):Includes 30 patients received 0.25% plain bupivacaine at 0.5 ml/Kg as the three in one FNB. Routine monitoring (non-invasive blood pressure, heart rate, oxygen saturation) were done before and during the procedure. Onset of sensory and motor block, duration of sensory and motor block, degree of sedation, postoperative pain, analgesic requirements and the complications were recorded. The results of our study showed that the ultrasound guided three in one FNB was successful in all patients included with no complications. Also it showed that three in one FNB with levobupivacaine had a faster onset of sensory and motor block and shorter duration of motor block compared with bupivacaine, on the other hand both drugs equal in terms of the duration of sensory block, postoperative pain scores and the amount of the analgesia required. Conclusion Form the results of our study we can concluded that the use of 0.5 ml/Kg of levobupivacaine at a concentration of 0.25% in the ultrasound guided three in one FNB achieved the same degree of sensory block with less degree of motor block compared to the same concentration of bupivacaine, |