This article is part of the supplement: Selected articles from the XXV National Congress of the Italian Society of Geriatric Surgery

Open Access Research article

Comparative study between Levobupivacaine and Bupivacaine for hernia surgery in the elderly

Rita Compagna4*, Gabriele Vigliotti4, Guido Coretti4, Maurizio Amato4, Giovanni Aprea4, Alessandro Puzziello1, Carmelo Militello2, Fabrizio Iacono3, Domenico Prezioso3 and Bruno Amato4

Author affiliations

1 Endocrinosurgery Unit, Dept of Medical and Surgical Sciences, University Magna Graecia, Italy Catanzaro, Italy

2 Department of Surgical and Gastroenterological Sciences, University of Padua, Italy

3 Department of Urology, School of Medicine, University “Federico II” of Naples, Italy

4 Department of General, Geriatric, Oncologic Surgery and advanced technologies, University "Federico II" of Naples, Via Pansini 5 - 80131 - Naples, Italy

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Citation and License

BMC Surgery 2012, 12(Suppl 1):S12  doi:10.1186/1471-2482-12-S1-S12

Published: 15 November 2012



The inguinal hernia is one of the most common diseases in the elderly. Treatment of this type of pathology is exclusively surgical and relies almost always on the use of local anesthesia. While in the past hernia surgery was carried out mainly by general anesthesia, in recent years there has been growing emphasis on the role of local anesthesia.


The aim of our study was to compare intra-and postoperative analgesia obtained by the use of levobupivacaine compared with that of bupivacaine. Bupivacaine is one of the main local anesthetics used in the intervention of inguinal hernioplasty. Levobupivacaine is an enantiomer of racemic bupivacaine with less cardiotoxicity and neurotoxicity. The study was conducted from April 2010 to May 2012. We collected data of forty male patients, aged between 73 and 85 years, who underwent inguinal hernioplasty with local anesthesia for the first time.


Minimal pain is the same in both groups. Mild pain was more frequent in the group who used bupivacaine, moderate pain was slightly more frequent in the group who used levobupivacaine, and the same for intense pain. It is therefore evident how Bupivacaine is slightly less preferred after four and twenty four hours, while the two drugs seem to have the same effect at a distance of twelve and forty-eight hours. Bupivacaine shows a significantly higher number of complications, as already demonstrated by previous studies. The request for an analgesic was slightly higher in patients receiving levobupivacaine.


After considering all these elements, we can conclude that the clinical efficacy of levobupivacaine and racemic bupivacaine are essentially similar, when used under local intervention of inguinal hernioplasty.