Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Anaesthesia

Spinal anesthesia is a very common technique used in orthopedic surgeries involving hip and lower limbs. It provides adequate analgesia both intra and post - operative and it also avoids complications associated with general anesthesia. Spinal block remains the first choice in these kinds of surgeries due to its rapid onset, superior blockade, low risk of infection as from catheter in situ in cases of epidural, less failure rates and cost effectiveness, but has the draw backs of shorter duration of block and lack of postoperative analgesia. Use of intrathecal adjuvants has gained popularity with the aim of prolonging the duration of block, better success rate and patient satis faction. 90 patients, ASA I / II were enrolled into the study. All patients had spinal anesthesia and randomly allocated into one of three groups. Group C: (30 patients): The patient received 15 mg of bupivacaine 0.5% plus 0.4 ml saline, Group M: (30 patients): The patient received 15 mg of bupivacaine 0.5% plus 0.4 ml of midazolam (2mg), Group D: (30 patients): The patient received 15 mg of bupivacaine 0.5% plus 0.1 ml dexmedetomidine (10 æg) plus 0.3 ml saline. In all groups assessment was done for time to reach T10 dermatome, time to peak sensory level, time to reach complete motor block (bromage 3), regression to S1 dermatome and time for motor recovery

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