levobupivacaine + lidocaine

Levobupivacaine + lidocaine is a combination of two amide-type local anesthetics used primarily for regional anesthesia, such as paravertebral block (PVB) and peribulbar block in surgical procedures. Levobupivacaine is the S-enantiomer of bupivacaine and provides long-lasting local anesthesia with a slower onset, while lidocaine offers a rapid onset but shorter duration of action. The rationale for combining these agents is to achieve both rapid onset (from lidocaine) and prolonged analgesia (from levobupivacaine). Both drugs act by blocking voltage-gated sodium channels in neuronal membranes, thereby inhibiting nerve impulse propagation and producing loss of sensation in the targeted area. This combination has been studied for use in breast surgery, cataract surgery, and other procedures requiring regional or local anesthesia[1][2][5].