[2] The drug typically starts taking effect within 15 minutes and can last up to 16 hours depending on factors such as site of administration and dosage.

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.

[7] 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.

[9][10] Possible adverse effects in the central nervous system caused by levobupivacaine usage are light-headedness, tinnitus, tongue numbness and convulsions, which may be due to the blockade of sodium, potassium and calcium channels in tissues that were not intended as targets.

[11] It is to note that the drug also has vasoconstrictive activity, thereby increasing the duration of sensory blockage with a relatively low risk of central nervous system toxicity on one hand, and on the other, it can have the same effect on uteroplacental blood flow, which can harm the foetus.

[7] Ultimately, levobupivacaine has been shown to have a lower risk of cardiovascular and central nervous system toxicity compared to bupivacaine in animal studies, not at the expense of potency and efficacy, and should be therefore considered as an alternative.

[7] It is important to adjust the dosage of levobupivacaine in paediatric patients due to their underdeveloped metabolic processing to prevent reaching toxic levels.

The dosage of local anaesthetics is calculated based on the patient’s weight and body mass index, however, the association power is stronger in children than in adults.

For example, drugs with a high pKa, such as that of levobupivacaine, tend to be their ionised form under physiological state, meaning that they would not easily cross the hydrophobic plasma membrane of cells.

Indeed, it has been found in certain studies that, as a surgical anaesthetic, it has a sensory ad motor blocking activity for over 90% of adult patients who received appropriate doses for their bodily composition, and duration of the surgery, with an onset time of 15 minutes.

[7] More specifically, levobupivacaine achieves its effects by acting on the neuronal voltage-sensitive sodium channels, where it prevents the transmission of nerve impulses.

[18] The normal function of these sodium channels is halted temporarily, as the drug interferes with their opening, thereby inhibiting the conduction of action potentials in nerves involved in sympathetic, sensory, and motor activity.

The lipophilic components of levobupivacaine allow it to cross cell membraness and exert its local anaesthetic effect by causing a reversible blockade of open neuronal sodium channels.

This method is claimed to be efficient, but showed to be dangerous for mass production due to the high risk of explosion of the diazonium salt intermediates.