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Postoperative Analgesic Effect of Locally Infiltrated Levobupivacaine in Fleur-de-Lys Abdominoplasty

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Abstract

Background

This prospective double-blind study compared the analgesic properties of locally infiltrated levobupivacaine with those of ropivacaine in fleur-de-lys abdominoplasty.

Methods

A total of 46 patients subjected to fleur-de-lis abdominoplasty under general anesthesia were included. The patients were randomly assigned to receive local infiltration of the peri-incisional and dissected area with the following solutions: group A (placebo group, n = 15) received 100 ml of saline 0.9%, group B (n = 15) received 50 ml of ropivacaine 0.75% in 50 ml of saline 0.9%, and group C (n = 16) received 60 ml of levobupivacaine 0.25% in 40 ml of saline 0.9%. The anesthetic technique was standardized for all the groups. The patients were asked to assess their pain at rest on a visual analog scale (VAS) at 2 h, 4 h, and 24 h postoperatively. Data were analyzed by mixed analysis of variance (ANOVA), simple ANOVA, and repeated measures ANOVA, followed by Tukey’s test.

Results

Groups B and C did not differ significantly in their VAS scores at 2 h postoperatively, but group C experienced significantly less pain (p < 0.001) than either the control group or the B group at 4 h and 24 h postoperatively. Group B also registered significantly lower VAS scores (p < 0.001) than the placebo group at 4 h postoperatively.

Conclusions

It is concluded that for mini abdominoplasty, adequate analgesia is achieved for at least 4 h postoperatively by local tissue infiltration with either ropivacaine or levobupivacaine. However, in terms of intensity and duration of analgesia, levobupivacaine was found to be more effective than ropivacaine in reducing postoperative pain associated with mini abdominoplasty.

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References

  1. Bardsley H, Gristwood R, Baker H: A comparison of the cardiovascular effects of levobupivacaine and rac-bupivacaine following intravenous administration to healthy volunteers. Br J Clin Pharmacol 46:245–249, 1998

    Article  PubMed  CAS  Google Scholar 

  2. Benhamou D, Ghosh C, Mercier FJ: A randomized sequential allocation study to determine the minimum effective analgesic concentration of levobupivacaine and ropivacaine in patients receiving epidural analgesia for labor. Anesthesiology 99:1383–1386, 2003

    Article  PubMed  CAS  Google Scholar 

  3. Casati A, Borghi B, Fanelli G: A double-blinded, randomized comparison of either 0.5% levobupivacaine or 0.5% ropivacaine for sciatic nerve block. Anesth Analg 94:987–990, 2002

    Article  PubMed  CAS  Google Scholar 

  4. Casati A, Chelly JE, Cerchierini E: Clinical properties of levobupivacaine or racemic bupivacaine for sciatic nerve block. J Clin Anesth 14:111–114, 2002

    Article  PubMed  CAS  Google Scholar 

  5. Cox CR, Checketts MR, MacKenzie N: Comparison of S(-)bupivacaine with racemic (RS)-bupivacaine in supraclavicular brachial plexus block. Br J Anaesth 80:594–598, 1998

    PubMed  CAS  Google Scholar 

  6. Denson DD, Behbehani MM, Gregg RV: Enantiomer-specific effects of an intravenously administered arrhythmogenic dose of bupivacaine on neurons of the nucleus tractus solitarius and the cardiovascular system in the anesthetized rat. Reg Anesth 17:311–316, 1992

    PubMed  CAS  Google Scholar 

  7. Fayman M, Beeton A, Potgieter E: Comparative analysis of bupivacaine and ropivacaine in infiltration analgesia for bilateral breast surgery. Aesth Plast Surg 27:100–103, 2003

    Article  Google Scholar 

  8. Forster RH, Markham A: Levobupivacaine: A review of its pharmacology and use as a local anaesthetic. Drugs 59:551–579, 2000

    Article  Google Scholar 

  9. Gristwood RW: Cardiac and CNS toxicity of levobupivacaine: Strengths of evidence for advantage over bupivacaine. Drug Saf 25:153–163, 2002

    Article  PubMed  CAS  Google Scholar 

  10. Huang YF, Pryor ME, Mather LE: Cardiovascular and central nervous system effects of intravenous levobupivacaine and bupivacaine in sheep. Anesth Analg 86:797–804, 1998

    Article  PubMed  CAS  Google Scholar 

  11. Kakagia D, Fotiadis S, Tripsiannis G: Comparative efficacy of ropivacaine and bupivacaine infiltrative analgesia in otoplasty. Ann Plast Surg 54:409–411, 2005

    Article  PubMed  CAS  Google Scholar 

  12. Kakagia D, Fotiadis S, Tripsiannis G: Levobupivacaine versus ropivacaine infiltration analgesia for mastopexy: A comparative study of 2 long-acting anesthetic drugs in infiltrative anesthesia for mastopexy. Ann Plast Surg 55:258–261, 2005

    Article  PubMed  CAS  Google Scholar 

  13. Kingsnorth AN, Cummings CG, Bennett DH: Local anaesthesia in elective inguinal hernia repair: A randomised, double-blind study comparing the efficacy of levobupivacaine with racemic bupivacaine. Eur J Surg 168:391–396, 2002

    Article  PubMed  Google Scholar 

  14. Klein JA: Anaesthesia for liposuction in dermatologic surgery. J Dermatol Surg Oncol 14:1124–1132, 1988

    PubMed  CAS  Google Scholar 

  15. Knudsen K, Beckman Suurkula M, Blomberg S: Central nervous and cardiovascular effects of IV infusions of ropivacaine, bupivacaine, and placebo in volunteers. Br J Anaesth 78:507–514, 1997

    PubMed  CAS  Google Scholar 

  16. Kopacz DJ, Allen HW, Thompson GE: A comparison of epidural levobupivacaine 0.75% with racemic bupivacaine for lower abdominal surgery. Anesth Analg 90:642–648, 2000

    Article  PubMed  CAS  Google Scholar 

  17. Launo C, Gastaldo P, Piccardo F: Perioperative thoracic epidural analgesia in aortic surgery: Role of levobupivacaine. Minerva Anestesiol 69:751–764, 2003

    PubMed  CAS  Google Scholar 

  18. Lee A, Fagan D, Lamont M: Disposition kinetics of ropivacaine in humans. Anesth Analg 69:736–738, 1989

    Article  PubMed  CAS  Google Scholar 

  19. Lee YY, Muchhal K, Chan CK: Levobupivacaine versus racemic bupivacaine in spinal anaesthesia for urological surgery. Anaesth Intensive Care 31:637–641, 2003

    PubMed  CAS  Google Scholar 

  20. Liisanantti O, Luukkonen J, Rosenberg PH: High-dose bupivacaine, levobupivacaine, and ropivacaine in axillary brachial plexus block. Acta Anaesthesiol Scand 48:601–606, 2004

    Article  PubMed  CAS  Google Scholar 

  21. Louizos AA, Hadzilia SJ, Leandros E: Postoperative pain relief after laparoscopic cholecystectomy: A placebo-controlled double-blind randomized trial of preincisional infiltration and intraperitoneal instillation of levobupivacaine 0.25%. Surg Endosc 19:1503–1506, 2005

    Article  PubMed  CAS  Google Scholar 

  22. Lyons G, Columb M, Wilson RC: Epidural pain relief in labour: Potencies of levobupivacaine and racemic bupivacaine. Br J Anaesth 81:899–901, 1998

    PubMed  CAS  Google Scholar 

  23. Mazoit J, Boico O, Samii K: Myocardial uptake of bupivacaine. II: Pharmacokinetics and pharmacodynamics of bupivacaine enantiomers in the isolated perfused rabbit heart. Anesth Analg 77:907–982, 1993

    Google Scholar 

  24. McClure JH: Ropivacaine. Br J Anaesth 76:300–307, 1996

    PubMed  CAS  Google Scholar 

  25. Mottura AA: The tumescent technique for facelifts? Plast Reconstr Surg 96:231–232, 1995

    Article  PubMed  CAS  Google Scholar 

  26. O’Donoghue JM, Chaubal ND, Haywood RM: An infiltration technique for reduction mammaplasty: Results in 192 consecutive breasts. Acta Chir Plast 41:103–106, 1999

    PubMed  CAS  Google Scholar 

  27. Peduto VA, Baroncini S, Montanini S: A prospective, randomized, double-blind comparison of epidural levobupivacaine 0.5% with epidural ropivacaine 0.75% for lower limb procedures. Eur J Anaesthesiol 20:979–983, 2003

    Article  PubMed  CAS  Google Scholar 

  28. Petterson N, Berggren P, Larsson M: Pain relief by wound infiltration with bupivacaine or high-dose ropivacaine after inguinal hernia repair. Reg Anesth Pain Med 24:569–575, 1999

    Article  Google Scholar 

  29. Scott DB, Lee A, Fagan D, Bowler G: Acute toxicity of ropivacaine compared with that of bupivacaine. Anesth Analg 69:563–569, 1989

    PubMed  CAS  Google Scholar 

  30. Striker AK: Breast reduction under local anaesthesia with intravenous sedation. Plast Reconstr Surg 99:256–257, 1997

    Google Scholar 

  31. Tabari K: Augmentation mammaplasty under local anaesthesia. Plast Reconstr Surg 43:320–322, 1969

    Article  PubMed  CAS  Google Scholar 

  32. Urbanek B, Duma A, Kimberger O: Onset time, quality of blockade, and duration of three-in-one blocks with levobupivacaine and bupivacaine. Anesth Analg 97:888–892, 2003

    Article  PubMed  CAS  Google Scholar 

  33. Whiteside JB, Woldsmith JAW: Developments in local anaesthetic drugs. Br J Anaesth 87:27–35, 2001

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Despoina D. Kakagia.

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Kakagia, D.D., Fotiadis, S., Tripsiannis, G. et al. Postoperative Analgesic Effect of Locally Infiltrated Levobupivacaine in Fleur-de-Lys Abdominoplasty. Aesth Plast Surg 31, 128–132 (2007). https://doi.org/10.1007/s00266-006-0187-4

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