الفهرس 
ANATOMY OF VERTEBRAEOnly 14 pages are availabe for public view
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Abstract
Spinal anesthesia with local anesthetic agents and adjuvant is extensively used for lower abdominal surgery. it provides excellent pain relief as compared to intravenous or epidural route. Various adjuvants have been added to intrathecal bupivacaine like morphine, clonidine and neostigmine to prolong the duration of spinal anesthesia. Intrathecal opioid prolong the duration of postoperative analgesia but at the same time has other adverse effects like itching, nausea, urinary retention, sedation, ileus and life threatening respiratory depression The aim of our study is to compare safety and efficacy of intrathecal dexmedetomidine ,dexamethasone or fentanyl as adjuvant to bupivacaine in hemorrhoidectomy.