الفهرس 
Anatomy of the Spinal Cord and the Vertebral ColumnOnly 14 pages are availabe for public view
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Abstract
Background: Many adjuvant drugs are added to bupivacaine to prolong the duration of sensory block like opioids and dexamethasone.
Objective: The aim of this thesis was to study the effect of adding fentayl or dexamethasone or their combination as an adjuvants to bupivacaine in intrathecal injection regarding the onset and the duration of sensory and motor block, postoperative analgesic requirement, the effect on hemodynamics and occurrence of any adverse effect.
Patients and Methods: In our study, 40 patients were randomly divided into four equal groups, group A received 3.5 ml hyperbaric bupivacaine 0.5 % +1.5 ml normal saline, group B received 3.5 ml hyperbaric bupivacaine 0.5 % + 0.5 ml (25µg) fentanyl + 1 ml normal saline. group C received 3.5 ml hyperbaric bupivacaine 0.5% + 1 ml (4 mg) dexamethasone + 0.5 ml normal saline. group D received 3.5 ml hyperbaric bupivacain 0.5% + 0.5 (25 µg) fentanyl + 1 ml (4 mg) dexamethasone.
Results: Our study showed that addition of 4 mg dexamethasone and 25 µg fentanyl to bupivacaine in intrathecal injection shortened the onset times of sensory and motor blocks and significantly prolonged their duration, It also save the hemodynamics and cause less adverse effects. This makes fentanyl and dexamethasone with bupivacaine more superior than using bupivacaine alone or with either fentanyl or dexamethasone.
Conclusion: Addition of both fentanyl and dexamethasone to bupivacaine in intrathecal injection shortend the onset time and increase the duration of both sensory and motor blockad, and on top decrease postoperative pain and analgesic requierments.