Bupivacaine exists as a mixture of two enantiomers, levobupi-vacaine and dexbupivacaine. Data suggests that levobupivacaine has equal local anesthetic potency, with reduced potential for central nervous system and cardiovascular toxicity. This study compares the clinical efficacy of 0.5% levobupivacaine with 0.5% bupivacaine and 0.5% ropivacaine, with and without fentanyl for epidural anesthesia in lower abdominal surgery. Also this study compare the cardiac inhibitory effect of the three drugs on isolated rabbit heart. Sixty patients completed the study and the patients were randomized to receive either of three drugs with and without fentanyl in a double-blind fashion.The efficacy endpoint measures included sensory onset and duration, motor block duration, hemodynamic variables, and the time to first request for postoperative analgesia. Also, the effect of each drug on the prolongation of QRS complex in isolated rabbit heart were recorded.The results of this study demonstrated that the sensory onset was significantly shorter and the sensory duration was significantly longer in levobupivacaine and fentanyl group in comparison to other groups. The motor duration was similar in levobupivacaine and bupivacaine groups while it was significantly shorter in ropivacaine group. No significant differences between the groups as regards the mean arterial blood pressure and heart rate. Also, levobupivacaine resulted in less cardiac inhibitory effect and less arrthythmogenic, in the experimental study.