الفهرس 
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Abstract
This study was carried out on sixty patients of either sex submited for elective lower orthopedic surgeries at Emergency Hospital, Mansoura University . Each patient was randomly assigned to either one of three groups (20 patient each) according to the studied local analgesic regimen:
Control group ,received 12.5 mg bupivacaine, Neostigmine group, received 25ug IT neostigmine and 12.5 mg bupivacaine and Morphine group received 100ug IT morphine and 12,5 mg bupivacaine
Pain , nausea and vomiting, pruritus , hemodynamic ; blood pressure, pulse and respiratory rate and arterial blood gases (PaCO2) were monitored both pre, intra and postoperatively . Adequacy of postoperative analgesia was recorded using pain score (Samii et al.,1981). Nausea and vomiting were assessed using Jorgensen et al, (2000) score
The data were analyzed in two approaches ; intragroup approach in which the basal value for each parameter included in the study statistically compared with subsequent values recorded at different intervals(basal reading, 5,10,15 min after ITI and then every 15min till end of surgery,and at 1,2,3,6,12, and24hours postoperatively) and intergroup approach entitled a statistically comparison between simultaneous recording of each individual parameters between the three groups.