Levobupivacaine hydrochloride

An amide local anesthetic used in medical procedures

Levobupivacaine hydrochloride is a long-acting amide local anesthetic used in various medical procedures to provide analgesia and anesthesia. It is the S-enantiomer of bupivacaine, which is known for its lower cardiotoxicity compared to the racemic mixture. Levobupivacaine is commonly used in epidural anesthesia, nerve block, and infiltration anesthesia.

Pharmacology

Levobupivacaine works by blocking sodium channels on the neuronal cell membrane, which inhibits the initiation and conduction of nerve impulses. This action results in a reversible loss of sensation in the area where the drug is administered.

Pharmacokinetics

Levobupivacaine is highly protein-bound (approximately 97%) and is metabolized in the liver. Its elimination half-life is approximately 1.3 hours, and it is primarily excreted by the kidneys.

Clinical Use

Levobupivacaine is used in various clinical settings, including:

• Epidural anesthesia for labor and delivery
• Peripheral nerve block for surgical procedures
• Infiltration anesthesia for minor surgical procedures

Safety and Side Effects

Levobupivacaine is generally well-tolerated, but like all local anesthetics, it can cause side effects. Common side effects include:

• Hypotension
• Bradycardia
• Nausea
• Dizziness

Severe side effects are rare but can include cardiotoxicity and central nervous system toxicity, especially if the drug is inadvertently injected intravascularly.

Comparison with Bupivacaine

Levobupivacaine is preferred over racemic bupivacaine in certain clinical situations due to its reduced potential for cardiotoxicity. This makes it a safer option for patients with cardiovascular concerns.

Also see

• Local anesthetic
• Bupivacaine
• Ropivacaine
• Lidocaine