Background:

Spinal anesthesia is a widely preferred technique for lower abdominal and urological surgeries due to its rapid onset and effective sensory and motor blockade. Among the commonly used agents for neuraxial blockade are bupivacaine and its S-enantiomer, levobupivacaine. While both are amide-type local anesthetics, levobupivacaine was developed to reduce the cardiotoxicity and neurotoxicity associated with racemic bupivacaine. Despite their widespread use, comparative data on the efficacy and safety of these procedures in urology remain limited.

Objective:

To compare the efficacy and safety of 0.5% hyperbaric bupivacaine versus 0.5% isobaric levobupivacaine in spinal anesthesia for patients undergoing elective urological surgeries.

Method:

This is a prospective, randomized clinical study. Patients scheduled for elective urological surgeries will be randomly assigned to receive either 0.5% hyperbaric bupivacaine or 0.5% hyperbaric levobupivacaine via spinal anesthesia. Parameters assessed will include onset time, peak block level, duration of sensory and motor blockade, intraoperative hemodynamic changes, and incidence of adverse effects. All clinical and safety parameters will be systematically recorded and analyzed.

Outcome:

The study will determine the comparative onset and duration of anesthesia, hemodynamic stability, incidence of side effects, and overall clinical efficacy of the two drugs in urological surgeries.

Significance:

By providing head-to-head data on bupivacaine and levobupivacaine in the specific context of urological procedures, this study aims to guide anesthetic drug selection, particularly for patients with cardiovascular risk factors or requiring tailored anesthetic plans. The findings could contribute to safer and more effective spinal anesthesia practices.