الفهرس 
Anatomy of the spineOnly 14 pages are availabe for public view
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Abstract
Epidural anesthesia and analgesia can provide a relief from pain for a longer duration and the facility of further top-ups and continuous infusion of the analgesic drugs through epidural catheter thus provides smooth recovery. Adjuvants are co-administered with local anesthetics to improve the speed of onset, duration of analgesia and to reduce the dose thereby eliminating quite a few side effects associated with larger doses. Various adjuvants have been added to epidural bupivacaine like morphine, clonidine and neostigmine to prolong the duration of epidural anesthesia. Epidural opioid prolong the duration of postoperative analgesia but at the same time has other adverse effects like itching, nausea, urinary retention, sedation, ileus and respiratory depression. The aim of this study is to compare between the analgesic effect of two doses of dexemdetomidine and fentanyl as adjuvant to bupivacaine in epidural anesthesia in lower limb surgery. Eighty adult patients of both sex of ASA physical status I and II scheduled for lower limb surgery. Patients with absolute or relative contraindication to epidural anesthesia were excluded.