INTRODUCTIONSpinal anesthesia is a safe, convenient and economical form of regional anesthesia technique. It results in sympathetic blockade, sensory analgesia, and motor blockade depending on the dose, concentration or volume of local anesthetic agent administered.1 Bupivacaine is the most common local anesthetic agent used. The desired effect is to block the transmission of nerve signals to and from the affected area. Spinal anesthesia has many advantages over general anesthesia which makes it the anesthesia of choice in the present surgical practice. Its advantages include: 3 Profound muscle relaxation, decreased intra-operative blood loss, preferable in patients suffering from respiratory diseases, early return of gastrointestinal function after surgery, suppress the neuroendocrine response to surgery, better analgesia than parenteral opioids in the postoperative period, reduce perioperative ABSTRACT Background: This study evaluated the effects of adding Fentanyl 12.5 mcg to hyperbaric Bupivacaine 0.5% for spinal anesthesia with regards to the onset of sensory block, maximum sensory level reached and the time to achieve it, time to two dermatome segment regression, onset of motor block, time for maximum motor blockade, duration of motor block, hemodynamic parameters and incidence of side effects. Methods: Sixty patients, male and female, ASA I or ASA II, aged 18 to 65 years scheduled for elective lower abdominal and lower extremity surgeries were randomized into two groups. Group C (Control group) received 0.5% hyperbaric bupivacaine 13 mg (2.6 ml) and Group S (Study group) received 0.5% hyperbaric bupivacaine 13 mg (2.6 ml) and 12.5 mcg of fentanyl (0.25 ml). Intraoperatively, sensory parameters were assessed by pin-prick method and motor parameters were assessed by modified Bromage scale at different time intervals. Haemodynamic parameters were monitored and side effects were also observed. Results: Both groups were comparable with respect to age, height, weight and duration of surgery. There was statistically significant difference with regard to the onset of sensory block, maximum dermatome level, time to achieve it and time to two segment regression between the two groups. Motor parameters did not differ. Conclusions: It was concluded that the addition of 12.5 mcg Fentanyl to 13 mg of hyperbaric Bupivacaine 0.5% for spinal anesthesia significantly decreases the onset of sensory block, enhances the maximum dermatome level and also prolongs the time to segment regression with better hemodynamic stability.

Background: Haemodynamic variation during layngoscopy/intubation is always a matter of concern for Anesthesiologists. A stable circulatory system is the wish of all performing general anaesthesia. Hence an acceptable and easy method needs to be established to prevent the haemodynamic variations. Our aim was to evaluate the effect of intravenous Dexmedetomidine (1µg/kg) infusion in obtunding the pressor response to laryngoscopy and tracheal intubation compared to intravenous preservative free 2% Lignocaine (1.5mg/kg). Methods: In this study, 60 patients, aged between 18-60 years belonging to ASA I and II are included. They were randomly divided into 2 groups, each comprising of 30. In group D, patients were given Dexmedetomidine 1µg/kg IV infusion over 10min and in group L, patient were given Lignocaine 1.5mg/kg IV. Results: In group D, the systolic, diastolic, mean arterial pressure and heart rate decreased significantly, from baseline, at first, second, third, fourth and fifth minute post intubation. In group L, the systolic, diastolic, mean arterial pressure and heart rate increased from baseline at first and second minute and then decreased at third, fourth and fifth minute post intubation. Conclusions: When compared between the two groups all the hemodynamic parameters showed statistical significance. There are no significant side effects and severe haemodynamic variability like hypotension and bradycardia. Therefore we concluded that Dexmedetomidine is superior to lignocaine in blunting the hemodynamic response to laryngoscopy and endotracheal intubation without any significant side effects.