Levobupivacaine, the S(-)-enantiomer of bupivacaine has been developed as an alternative to the racemic mixture, as it has been shown to have a lower cardiotoxicity than bupivacaine. Under European Union advice, it can be applied for minor and major surgical anaesthesia, as well as (post-operative) pain management. Particularly, it has been found suitable for multiple procedures, such as epidural block. It is effective for human patients who receive elective Caesarean section or lower body surgery, as it does not diverge dramatically in terms of sensory and/or motor block duration in comparison to bupivacaine. Deserving of consideration is the fact that its enhanced motor blocking can be a downside for patients receiving an epidural injection during childbirth, as a certain level of movement may still be required.
Other than childbirth, possible applications of levobupivacaine include upper and lower limb surgery, as well as eye surgery, where it blocks the extraocular muscle, highly efficient and convenient for patients undergoing vitreoretinal anterior segment or cataract surgery.
Levobupivacaine can be combined with other analgesics, including opioids, for postoperative pain management.