Efficacy of Epidural Levobupivacaine on the Treatment of Post-Operative Pain

Abstract

  Bupivacaine has a chiral center and is currently available as a racemic mixture of its two enantiomers: R (+)-bupivacaine and S (-)-bupivacaine. Levobupivacaine is a drug which consists of only S (-)- bupivacaine. One criticism of bupivacaine is its toxicity to either the central nervous system or cardiovascular system. It has been demonstrated that there is enantiomer selectivity of action with the bulk of central nervous system and cardiovascular toxicity residing with the R (+) isomer. Thus, levobupivacaine is less toxic to either the central nervous system or the cardiovascular system than bupivacaine. Moreover, levobupivacaine has reported to have less effect on motor function than bupivacaine. These characteristics of levobupivacaine are good for using post-operative pain management. Levobupivacaine is more potent than ropivacaine and has similar efficacy to ropivacaine. These data strongly suggest that levobupivacaine is a suitable epidural drug for post-operative pain management.