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Abstract
Spinal anesthesia is the preferred means for cesarean section, being simple to perform, economical and produces rapid onset of anesthesia and complete muscle relaxation. It carries high efficiency, involves less drug doses, minimal neonatal depression, a wake mother and lesser incidences of aspiration pneumonitis. However, Cesarean delivery requires traction of peritoneum and handling of intraperitoneal organs, resulting in intraoperative visceral pain that leads to use a higher dose of local anesthetics and increased incidence of adverse effects. Bupivaciane, an amid type of local anesthetics, has high potency, and long duration of action. however, intrathecal (IT) bupivacaine alone may be insufficient to provide complete analgesia, despite the high sensory block. Large doses of IT bupivacaine were associated with severe hypotension and delayed motor recovery. Therefore, smaller doses of bupivacaine supplemented by IT opioids have been recommended for spinal anesthesia in patients undergoing cesarean delivery to improve the antinociceptive effects of local anesthetics. Fentanyl is being used intrathecally, together with hyperparic bupivacaine in cesarean section to improve the antinociceptive effect,deceases the dose and adverse effects .