الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Spinal anesthesia for lower body surgeries may be the preferred anesthetic technique as it is simple to perform with rapid onset of anesthesia and complete muscle relaxation. Elderly patients are at increased anesthetic risk due to their lack of physiologic reserve. Accordingly, elderly patients are a particularly appealing population for anesthetic techniques that have the potential to reduce anesthetic risk. Intrathecal opioids are synergistic with local anesthetics and intensify the sensory block without increasing the sympathetic block. They are commonly added to local anesthetics for potentiating their effects. The aim of this study was to compare the intra and postoperative analgesic effect of intrathecal nalbuphine and fentanyl as adjuvants to bupivacaine during lower body surgeries in elderly. Seventy patients, scheduled for elective lower body surgeries, were included in that study and divided into two groups: group (N): Intrathecal nalbuphine 0.8 mg adjuvant to 2.5 ml 0.5% hyperbaric bupivacaine. group (F): Intrathecal fentanyl 20 μg adjuvant to 2.5 ml 0.5% hyperbaric bupivacaine. There was statistically significant difference between the two groups as regard First analgesic request, where it was longer in group (N) than in group (F). Denoting that nalbuphine could be more effective than fentanyl. There was statistically significant difference between the two groups as regard total ketorolac consumption and total Pethidine consumption, where ketorolac and Pethidine consumption was more in group (F) than group (N). There was a significant difference in the VAS score at 24 h postoperatively. Regarding intra-operative side effects, as regard metoclopramide and occurrence of shivering were more in group (F) than group (N). Denoting that side effects might be more with fentanyl. No significant difference was detected between the two groups regarding: This study concluded that Nalbuphine (0.8 mg) as intrathecal adjuvants to 0.5% hyperbaric bupivacaine prolongs the duration of sensory and motor block, the effective duration of analgesia, decrease the incidence of intraoperative side effects more efficiently than fentanyl in patients scheduled for elective lower body surgery under subarachnoid block.