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Background: Epidural anesthesia is one of the best options for lower abdominal and lower limb surgery. However, therehave been insufficient reports regarding the use of epidural anesthesia for pilonidal sinus surgery. The present study wasperformed to compare the clinical profiles of epidural block performed with 0.75% levobupivacaine and 0.75% ropivacainein this procedure. Methods: Thirty patients undergoing pilonidal sinus surgery were randomly allocated into two groups: one group receivedlevobupivacaine and the other received ropivacaine at 0.75% in a volume of 10 ml. Arterial blood pressure, heartrate, oxygen saturation, the onset time of analgesia and duration of block, highest sensory block level, perioperative andpostoperative side effects, and patients’ and surgeons’ satisfaction were recorded. Results: Hemodynamic stability was maintained in both groups throughout surgery. The onset time of analgesia (thetime from epidural injection of local anesthetic to reach L2 sensorial block) was 6.26 ± 3.49 min in the levobupivacainegroup and 4.06 ± 1.75 min in the ropivacaine group (P = 0.116). The duration of sensorial block (time for regression ofsensory block to L2) was 297.73 ± 70.94 min in group L and 332.40 ± 102.22 min in group R (P = 0.110). Motor block wasnot seen in any of the patients in the study groups. Patients’ and surgeons’ satisfaction with the anesthetic technique weremostly excellent in both groups. Conclusions: In patients undergoing pilonidal sinus surgery, both levobupivacaine and ropivacaine produce rapid andexcellent epidural block without leading to motor block or significant side effects. Although not statistically significant,the onset time of anesthesia was shorter and the duration of effect was longer with ropivacaine than with levobupivacainein this study.

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