Levobupivacaine versus Bupivacaine for Spinal Anesthesia in Jackknife Position: A Randomized Trial in Pilonidal Sinus Surgery

Abstract

Background: This study aimed to compare the efficacy and clinical characteristics of levobupivacaine and bupivacaine for spinal anesthesia in the jackknife position during pilonidal sinus surgery. Materials and Methods: The onset and maximum level of sensory block were similar between groups. Regression to S2 occurred significantly earlier in the levobupivacaine group (139.7 ± 7.3 min) compared with the bupivacaine group (165.2 ± 8.0 min, p=0.001). The duration of motor block was also shorter in the levobupivacaine group (125.8 ± 6.5 vs. 148.5 ± 7.2 min, p=0.001). Hemodynamic stability and side-effect profiles were comparable between groups. Results: The onset and maximum level of sensory block were similar between groups. Regression to S2 occurred significantly earlier in the levobupivacaine group (139.7 ± 7.3 min) compared with the bupivacaine group (165.2 ± 8.0 min, p=0.001). The duration of motor block was also shorter in the levobupivacaine group (125.8 ± 6.5 vs. 148.5 ± 7.2 min, p=0.001). Hemodynamic stability and side-effect profiles were comparable between groups. Conclusions: Levobupivacaine provides shorter motor block duration and faster recovery compared with bupivacaine, making it particularly suitable for short procedures performed in the jackknife position. Larger multicenter trials are warranted to validate these findings.