Rhinology,46,289-291,2008 *Receivedforpublication:January17,2008;accepted:May19,2008 INTRODUCTION The comfort of the patient is very important during and after the operations in which local anesthetics are used. The most important complaint is postoperative pain. Septoplasty with localanesthesiaisacommonprocedureinotolaryngologyclin- ics.However,therearefewstudiesonthereductionofpostop- erativepainaftersuchoperations. Postoperative pain is a phenomenon associated with surgical trauma and expression of pain mediators (1) . After septoplasty, the maximum level of pain is usually experienced within the first 24 hours during which patients need analgesic support. Prevention of pain development within this period decreases the anxiety caused by the pain and thus prevents the creation ofaviciouscycle (2) . Lidocaine is the most frequently used local anesthetic agent. Beingafast-actingagent,itcannotblockthepostoperativepain foralongtimebecauseofitsshorthalf-life.Thechemicaland pharmacologicalqualitiesofbupivacainearesimilartothoseof lidocaine. However, it starts acting in 2-10 minutes of applica- tionanditiseffectivefor7-8hours.Thus,itprovides2-3times longer analgesia than lidocaine does (3) . Levobupivacaine is the S enantiomer of bupivacaine. Despite having a similar level of efficacy as a local anesthetic, levo-bupivacaine has less car- diotoxicandneurotoxicpotentialthanbupivacaine (4) . The postoperative pain of patients operated using levo-bupiva- caine, a long-lasting local anesthetic, should start later than that of patients operated using lidocaine, and these patients should also require analgesic support later and need relatively lower amounts of analgesics. To substantiate this hypothesis, the levels of postoperative pain and need for postoperative analgesia of the patients who underwent septoplasty operation with levo-bupivacaine, a long-lasting anesthetic, and the patientswhounderwentseptoplastyoperationwithlidocaine,a short-livedinfiltrativeanesthetic,werecompared. MATERIALANDMETHODS Patients The study involved 112 patients with nasal septum deviation thatwerescheduledforseptoplastyunderlocalanesthetic.The mean age of the patients was 39.7 years (range: 19-53 years). The approval of the Ethics Committee was obtained. All the patients’vital signs were monitored during the operation. The patients who had ECG changes, additional nasal pathologies and thus receiving additional surgical interventions, hyperten- sion, asthma, diabetes mellitus, neurological diseases, and his- tory of allergies to local anesthetics were excluded from the study. The aim of this study is to compare the efficacy of levo-bupivacaine, a long-acting local anes- thetic and lidocaine in postoperative analgesia following septoplasty. . 112 patients randomized into two groups were included in the study. 56 patients were operated using levo-bupivacaine and 56 using lidocaine as the local anesthetic. All patients were asked to mark their pain levels on a Visual analogue scale (VAS) at 1 st ,2 nd ,4 th ,6 th ,8 th , 12 th , and 24 th hours postoperatively. In addition, the amount of analgesics used by each patient was recorded. The results indicated that the VAS scores of the levo-bupivacaine patients were significantly lower within the postoperative 4 hours (p < 0.05) compared to the lidocaine group. In the levo- bupivacaine patients the earliest time for analgesic need was delayed (p < 0.001) and the total amount of analgesics used was significantly lower when compared to lidocaine group (p < 0.001). In conclusion, levo-bupivacaine is effective for obtaining postoperative analgesia following sep- toplasty with local anesthesia. When compared to lidocaine, it increases the postoperative com- fort of the patients by reducing pain levels. Key words: septoplasty, local anesthesia, levo- bupivacaine, lidocaine, analgesia SUMMARY Comparisonoflevo-bupivacaineandlidocainefor postoperativeanalgesiafollowingseptoplasty* YavuzFuatYilmaz,SametOzlugedik,AliTitiz,AnilTuncay,MugeOzcan, AdnanUnal AnkaraNumuneEducationandResearchHospitalENTDepartment,Ankara,Turkey ORIGINALCONTRIBUTION