COMPARISON OF LEVOBUPIVACAIN AND ROPIVAKAIN IN COMBINED ANESTHESIA IN ONCOGNECOLOGICAL INTERVENTIONS

The aim of the study was to evaluate the nature of the development of the sensory block and the frequency of occurrence of critical incidents during anesthesia, in the immediate postoperative period using levobupivacaine and ropivacaine in patients with an oncogynecological profile. Materials and methods. The study included 48 women who were randomized into two groups of 24 patients each, depending on the anesthetic used: group 1 - ropivacaine, group 2 - levobupivacaine. The latent period of the sensory block, the motor block, the maximum level of development of the sensory block after 15 minutes, critical incidents at the stages of anesthesia, the level of the pain syndrome after extubation and coughing were analyzed in the groups. Results. The sensory response to the cold sample, after the administration of local anesthetics in the groups, differed: in the first group, 300 (241.25, 314.75) s, in the second group 54.5 (45.75, 60.25) s. The maximum level of the sensory block in the groups was different. During the induction and maintenance of anesthesia, the most common critical incident was hypotension. Reduction of systolic blood pressure for the induction of anesthesia in group 1 was detected in 6 (25%) cases, in group 2 in 7 (29%). After extubation, the pain syndrome in the first group was 1.7 (1; 6), in the second group 1.7 (1; 4). With a cough, the assessment of the pain syndrome had the same intensity of pain, both in the first and in the second group 2 (1; 3). Conclusions. Levobupivacaine with epidural anesthesia accelerates the development of the sensory block. The maximum level of the sensory block does not differ with the use of levobupivacaine and ropivacaine. Hypotension in the stages of anesthesia is a frequent critical incident in epidural anesthesia. The severity of the pain syndrome during extubation and in the immediate postoperative period does not depend on the selected anesthetic.

levobupivacaine, ropivacaine, combined anesthesia, epidural anesthesia, oncogynecology, digital rating pain scale, critical incidents, multimodal anesthesia