الفهرس 
IntroductionOnly 14 pages are availabe for public view
Abstract
Spinal anesthesia is the most commonly used technique for lower abdominal surgery. However, the local anesthetic-when used alone-is associated with relatively short duration of action, thus early analgesic intervention is needed in the postoperative period.
Dexmedetomidine can be added to local anesthetics in spinal anesthesia to decrease the time needed for the start of the block, decrease the pain severity postoperatively, increase the time of the block, and decrease the analgesic use postoperatively. It decreases the incidence of shivering through increasing vasodilatation and inhibition of central thermoregulation
Dexamethasone is known to modify the inflammatory reaction of the body and reduce the gradient between central and peripheral tissue temperatures that is why it has been used as an intravenous medication to decrease shivering.
It has been also used to be injected in the cerebrospinal fluid safely and can be given as an adjuvant to local anesthetics to enhance the efficacy of regional anesthesia
Addition of Intrathecal dexamethasone to Bupivacaine significantly improved the duration of sensory block in spinal anesthesia without any changes in onset time and complications.
The main aim of the study:
The main aim of this study was to compare the safety and efficacy of intrathecal dexmedetomidine versus dexamethasone as additive to bupivacaine in patients underwent lower abdominal surgeries under spinal anesthesia.
Methods:
This prospective, randomized, double-blinded, controlled clinical study was conducted in Faculty of Medicine; Ain-Shams University Hospitals. This study was conducted on 50 patients scheduled for lower abdominal surgeries under spinal anesthesia. All patients were divided into 2 groups: group A included 25 patients received spinal anesthesia with 15 mg of 0.5% hyperbaric bupivacaine (3ml) + 4mg of Dexamethasone (1ml) and group B 25 patients received spinal anesthesia with 15 mg of 0.5% hyperbaric bupivacaine (3ml) + 5mcg dexmedetomidine (1ml).
The main results of the study showed that:
• There is no significant difference age, BMI, sex, operation types, ASA and operative time.
• There is no significant difference between the two studied groups regarding MAP, HR and spo2 at all measurement times.
• VAS score was significantly lower in group B compared to group A at 8hr and 12hr measurements.
• There is a significant difference between the groups regarding sensory block duration, motor block duration, onset of sensory block, onset of motor block, time to 2 segment regression, and time to request of 1st analgesia.
• Postoperative opioid consumption was significantly lower in group b compared to group a at all times.
• There is no significant difference regarding postoperative complications.