Levobupivacaine vs bupivacaine as infiltration anaesthesia in inguinal herniorrhaphy

We have compared the anaesthetic and analgesic efficacy of levobupivacaine with that of racemic bupivacaine in 66 male patients undergoing ambulatory primary inguinal herniorrhaphy. Patients were allocated randomly in a doubl e-blind manner to local infiltration anaesthesia (0.25%w/v 50 ml) with eith er racemic bupivacaine (n=33) or levobupivacaine (n=33). Scores for intraop erative pain and satisfaction with anaesthesia were recorded, together with perception of postoperative pain and need for supplementary postoperative analgesic medications in the first 48 h after operation. Intraoperative sat isfaction with the infiltration anaesthesia was similar, with median scores of 77 (levobupivacaine) and 80 (bupivacaine) (VAS; 100 mm=extremely satisf ied). Time averaged postoperative pain scores (48 h) were 8 (levobupivacain e) and 10 (bupivacaine) in the supine position, 13 (levobupivacaine) and 12 (bupivacaine) while rising from the supine position to sitting. and 9 (lev obupivacaine) and 13 (bupivacaine) while walking (VAS; 100 mm=worst pain im aginable) (ns). There was no difference in the use of peroral postoperative analgesics between the two groups. We conclude that racemic bupivacaine an d its S-enantiomer levobupivacaine had similar efficacy when used as local infiltration anaesthesia in inguinal herniorrhaphy.