Conclusions

Both ropivacaine and levobupivacaine provided reliable subarachnoid blockade and can be used for infraumbilical surgeries. Intrathecal levobupivacaine produced a longer sensory blockade and postoperative analgesia than ropivacaine but was also associated with a longer duration of motor blockade. These findings suggest a trade-off between prolonged analgesia and delayed motor recovery. Selection of the intrathecal agent should therefore be individualized according to the clinical priorities and surgical requirements. Both agents exhibit favorable cardiovascular safety profiles and serve as safer alternatives to bupivacaine for spinal anesthesia in infraumbilical procedures. The longer duration of motor blockade observed with levobupivacaine may delay ambulation in patients undergoing day-case surgery. Future multicenter studies with larger sample sizes and more diverse surgical populations may further validate these findings and help refine drug selection according to individual patient and procedural needs.