Levobupivacaine
Brand names: Chirocaine
Levobupivacaine is a long-acting amide local anaesthetic — the S-enantiomer of bupivacaine — used for surgical anaesthesia, regional blocks, and post-operative analgesia.
ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.
Clinical monograph
How it works
It reversibly blocks voltage-gated sodium channels in nerve membranes, preventing depolarisation and the propagation of nerve impulses.
Prescribing in practice
- Inadvertent intravascular injection can cause cardiac arrest and central nervous system toxicity; aspirate before injecting, use incremental dosing, and have lipid emulsion and resuscitation facilities available.
- It has a more favourable cardiotoxicity profile than racemic bupivacaine but the same precautions against systemic toxicity apply.
- It must never be used for intravenous regional anaesthesia (Bier's block).
Monitoring
Monitor cardiovascular and neurological status during and after injection for signs of local anaesthetic systemic toxicity.
Counselling the patient
- The treated area will feel numb and weak until the block resolves; protect it from injury.
- Report any dizziness, ringing in the ears, a metallic taste, or numbness around the mouth immediately.
Evidence & guidelines
Use is supported by product information and regional anaesthesia practice; refer to current prescribing references and the SPC.
Reference: AAGBI LAST Guidelines 2023; OAA (Obstetric Anaesthetists Association) Guidelines; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).
Related
Curated clinical cross-links plus same-class fallbacks.