scholarly journals Comparative study of hyperbaric 0.5% bupivacaine and hyperbaric 0.5% bupivacaine with low dose dexmedetomidine in spinal anaesthesia

2017 ◽  
Vol 6 (2) ◽  
pp. 410
Author(s):  
Shriganesh D. Kamat ◽  
Nitin N. Puram ◽  
Prakash R. Dhumal ◽  
Pushpa I. Agrawal ◽  
Jaiprakash B. Ramanand ◽  
...  
Keyword(s):  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Low Dose ◽  
Control Group ◽  
Spinal Block ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Group B ◽  
Randomised Controlled

Background: Spinal anaesthesia remains one of the basic techniques in the arsenal of modern anaesthesiology despite the waxing and waning of its popularity over last 100 years since its introduction into clinical practice.It avoids biochemical and metabolic changes consequent to the stress of general anesthesia for surgery as well as provides near optimal conditions for surgery. In present study, we tried to study effectiveness of intrathecal 0.5% heavy bupivacaine alone with Dexmedetomidine as an adjuvant to intrathecal 0.5% heavy bupivacaine for lower limb and lower abdominal surgeries.Methods: The present study was conducted in the department of anaesthesiology from December 2011 to September 2013.This study was a prospective, randomised controlled, single blind, study conducted in 100 patients of ASA grade I and II undergoing elective surgeries under spinal anaesthesia. The patients were divided randomly into two groups, containing 50 patients in each group. Dosages of drugs selected are divided as Group B: Patients received 3 ml of 0.5% hyperbaric bupivacaine (15mg) and Group BD: Patients received 3 ml of 0.5% hyperbaric bupivacaine (15mg) plus 10 µg Dexmedetomidine. Spinal block characteristics, Mean arterial pressure, Mean pulse rate, sedation and side effects were studied during intra-operative and postoperative period.Results: It was found from present study that in Dexmedetomidine group time to reach T10 sensory blockade and complete motor blockade was earlier and a higher level of sensory blockade compared to control group achieved. Duration of sensory, motor blockade and duration of analgesia was significantly prolonged in the Dexmedetomidine group compared to the control group. Hemodynamic parameters were preserved both intra-operatively and postoperatively. However there were a small percentage of patients who developed hypotension and bradycardia which were easily managed without any untoward effect. Hence Dexmedetomidine is a better neuraxial adjuvant for providing early onset of sensory and motor blockade, prolonged sensory blockade and post operative analgesia and adequate sedation.Conclusions: Intrathecal low dose Dexmedetomidine in a dose of 10µg along with 0.5% hyperbaric bupivacaine is an addition into anaesthesiologist's armamentarium for spinal anaesthesia in patients undergoing elective lower abdominal and lower limb surgeries.

Compare the Analgesic Efficacy of Dexmedetomidineand Fentanyl as an Adjuvant to Bupivacaine for Lower Limb Surgery

2021 ◽  
Vol 15 (6) ◽  
pp. 2153-2155
Author(s):  
Arshi Naz ◽  
Mirza Shahzad Baig ◽  
Vijai Kumar ◽  
Samita S Khan ◽  
Sidra Javed ◽  
...  
Keyword(s):  
Spinal Anaesthesia ◽  
Lower Limb ◽  
P Value ◽  
Hyperbaric Bupivacaine ◽  
Rescue Analgesia ◽  
Sensory Blockade ◽  
Significant Difference ◽  
Lower Limb Surgery ◽  
Group A ◽  
Group B

Objective: To compare the analgesic effectiveness of Dexmedetomidine and Fentanyl as an adjuvant to 0.5% Bupivacaine in spinal anaesthesia for patients undergoing lower limb surgery. Study Design: Randomized controlled trial. Place & Duration:The study was conducted at department of Anesthesia, Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi for duration from 15thJuly2020 to 15thFebruary 2021. Methods: In this study 52 patients of both genders undergoing lower limb surgeries were included. Patient’s ages were ranging from 20 to 70 years. All the patients were divided into two Groups. Group A included 26 patients and received Inj. Dexmedetomidine 10 μg in 0.5ml normal saline with 12.5mg of 0.5% hyperbaric bupivacaine, Group B had 26 patients and received 25mg fentanyl with 12.5mg of 0.5% hyperbaric bupivacaine. Time to achieve T10 blockade, time to first rescue analgesia were examined and compare between both groups. All the statistical data was analyzed by SPSS 24.0. P-Value <0.05 was significantly considered. Results: Mean age of group A was 40.52±12.28 years and in group B it was 40.14±13.34 years. There were 18 (69.23%) male patients and 8 (30.77%) females in group A while in Group B 19 (73.08%) patients were male and 7 (26.92%) were females. No significant difference was observed between both groups regarding time to T10 blockade with p-value >0.05. A significant difference was found regarding time to rescue analgesia, in Group A it was 426.58±92.44 minutes and in Group B, it was 206.44±48.47 minutes (p-value <0.0001). Patients’ satisfaction was high in dexemedetomidine group as compared to fentanyl group. Conclusion: Dexmedetomidine 10 μg with 0.5% bupvicaine showed better effectiveness regarding time to first rescue analgesia as compared to fentanyl. No significant difference was observed regarding time to sensory blockade between both medications. Keywords: Dexmedetomidine, Fentanyl, Spinal Anaesthesia, Lower Limb Surgery, Sensory Block, Analgesia

scholarly journals Comparing the Analgesic Efficacy of Intrathecal Bupivacaine Alone with Intrathecal Bupivacaine Midazolam or Magnesium Sulphate Combination in Patients Undergoing Elective Infraumbilical Surgery

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Josef Attia ◽  
Amany Abo Elhussien ◽  
Mostafa Zaki
Keyword(s):  
Side Effects ◽  
Magnesium Sulphate ◽  
Lower Limb ◽  
Analgesic Efficacy ◽  
Motor Blockade ◽  
Sensory Blockade ◽  
Lower Limb Surgery ◽  
Group A ◽  
Group B ◽  
Limited Duration

Background. Spinal anaesthesia, which is one of the techniques for infraumbilical surgeries, is most commonly criticized for limited duration of postoperative analgesia. Aim of the Work. The aim of this study was to decrease bupivacaine dose used in spinal anesthesia in patients undergoing orthopedic lower limb surgery and reduce its possible side effects. Patient and Methods. Sixty adult patients of both sexes, divided into three. Group C received 2.5 mL bupivacaine and 0.5 mL saline 0.9%. Group A received 2.5 mL bupivacaine and 0.5 mL midazolam. Group B received 2.5 mL bupivacaine and 0.5 mL magnesium sulphate. Results. As regards onset of both motor and sensory blockade, there are a significant decrease in group A and a significant increase in group B as compared to group C, with a significant decrease in duration of motor blockade and significant increase in duration of sensory blockade in both group A and group B, respectively, as compared to group C, with a significant decrease in the duration of sensory blockade in group B as compared to group C. Conclusions. These results suggested that intrathecal midazolam as an adjuvant for bupivacaine increases the duration of both sensory and motor blockade more than that of magnesium sulphate.

scholarly journals A COMPARISION OF INTRATHECAL HYPERBARIC BUPUVACAINE WITH BUPRENORPHINE AND HYPERBARIC BUPIVACAINE ALONE IN GYNAECOLOGICAL SURGERIES FOR POSTOPERATIVE ANALGESIA

2021 ◽  
Vol 9 (06) ◽  
pp. 773-777
Author(s):  
Archana Jadhav ◽  
◽  
Rashmi Bengali ◽  
Keyword(s):  
Blood Pressure ◽  
Respiratory Rate ◽  
Spinal Anaesthesia ◽  
Tertiary Care ◽  
Tertiary Care Centre ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Duration Of Surgery ◽  
Group B ◽  
Effective Analgesia

This study was performed at a tertiary care centre after the approval of the Institutional Ethical Committee and obtaining written informed consent from all patients. Sixty ASA I and II, aged 18- 65yrs, bodyweight 45-70kgs scheduled for gynaecological surgeries under spinal anaesthesia were chosen for the study and were divided into two groups named Group B and Group BN each comprising 30 patients. Group B received 3ml of 0.5% hyperbaric bupivacaine with 0.5 ml normal saline and Group BN received 3ml of 0.5% hyperbaric bupivacaine with 0.5ml (150mcg) of buprenorphine. Vital parameters like pulse rate, blood pressure, respiratory rate, SpO2 were recorded at 0 (basal) 15, 30, 45, 90 and 180 minutes. Postoperatively heart rate, blood pressure, respiratory rate and SP02 were monitored at 3 ,6 ,12 and 24 hrs. The mean age, height, weight, duration of surgery were comparable. Time of onset of sensory blockade and motor blockade were noted. The time for rescue medication was 909.0±216.9 min in group BN with a range from 690 min to 1500 min and in group B it was 412.0±89.28 min with a range from 130 min to 195 min. Comparing both groups duration of effective analgesia was significantly higher in group BN with P<0.0001.thus, it can be concluded that addition of buprenorphine as an adjuvant in spinal anaesthesia excellently prolongs duration of analgesia in postoperative period with minimal side effects.

scholarly journals A comparative study of intrathecal bupivacaine and levobupivacaine for patients undergoing caesarean section

2019 ◽  
Vol 6 (6) ◽  
pp. 1792
Author(s):  
Kiranpreet Kaur ◽  
Sanjay Johar ◽  
Anil Kumar ◽  
Mamta Jain ◽  
Prashant Kumar ◽  
...  
Keyword(s):  
Caesarean Section ◽  
Onset Time ◽  
Sensory Block ◽  
P Value ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Sensory Blockade ◽  
Pregnant Females ◽  
Haemodynamic Stability ◽  
Group B

Background: The present study was conducted to compare the effects of 0.5% isobaric levobupivacaine and 0.5% hyperbaric bupivacaine in pregnant females undergoing caesarean section.Methods: Study was conducted on 100 pregnant females undergoing caesarean section. They were randomly divided into two groups B and L receiving 2 ml of 0.5% hyperbaric bupivacaine and 0.5% levobupivacaine respectively. Two groups were compared with regard to sensory block, motor block, haemodynamic stability and complications if any.Results: Time to achieve sensory blockade till T6 dermatome was prolonged in group B (162.52±80.55 sec) as compared to group L (139.40±49.79 seconds) (p value= 0.087). Prolonged duration of motor blockade was observed in group B (160.76±6.56 minutes) as compared to group L (131.48±14.42 minutes) (p<0.001). Less haemodynamic stability was seen in patients of group B with more incidence of hypotension and bradycardia.as compared to group L.Conclusions: Levobupivacaine is nearly equally effective to bupivacaine to produce sensory and motor blockade with comparable onset time and better haemodynamic stability with lesser side effects.

scholarly journals PERIOPERATIVE EFFECTS OF INTRATHECAL CLONIDINE AND FENTANYL WITH HYPERBARIC BUPIVACAINE IN SPINAL ANESTHESIA FOR VAGINAL HYSTERECTOMY

2016 ◽  
Vol 9 (5) ◽  
pp. 245
Author(s):  
Suman Chattopadhyay ◽  
Mallika Datta ◽  
Biswanath Biswas
Keyword(s):  
Placebo Group ◽  
Spinal Anesthesia ◽  
Low Dose ◽  
Mechanisms Of Action ◽  
Spinal Block ◽  
Hyperbaric Bupivacaine ◽  
Prolonged Duration ◽  
Group A ◽  
Group B ◽  
Intrathecal Clonidine

ABSTRACTObjectives: Intrathecal fentanyl and clonidine are effective analgesics with different mechanisms of action. This study compares 25 µg of both thesedrugs given intrathecally regarding onset, quality, and duration of hyperbaric bupivacaine-induced spinal block and side effects.Methods: A total of 90 patients of ASA I and II were randomly allocated into three equal groups. Group A received 0.5 ml of 0.9% normal saline(placebo), Group B and Group C received 25 µg fentanyl and clonidine intrathecally added to 2.5 ml of 0.5% hyperbaric bupivacaine, respectively. Theonset and regression time of sensory and motor blocks were recorded along with hemodynamic change, side effects, pain intensity (in terms of visualanalog score (VAS), and time to first rescue analgesic.Results: Intrathecal clonidine (25 μg) significantly prolongs sensory and motor blocks, with prolonged duration of analgesia in comparison withintrathecal fentanyl (25 µg) (325±15 minutes vs. 240±7.6 minutes). VAS score was similar, but sedation was more in clonidine group.Conclusion: We conclude that low-dose intrathecal clonidine is an effective adjuvant to bupivacaine for spinal anesthesia and provides betterpostoperative analgesia in comparison with intrathecal fentanyl.Keywords: Clonidine, Fentanyl, Bupivacaine, Regional, Spinal, Postoperative pain.

scholarly journals Evaluating the effect of dexmedetomidine premedication on the quality of subarachnoid block, haemodynamics and sedation in patients undergoing lower limb surgeries: a prospective randomized controlled trial

2017 ◽  
Vol 5 (12) ◽  
pp. 5410
Author(s):  
Sandeep Sharma ◽  
Mahesh Somani ◽  
Madhan Chandramohan ◽  
Lalit Kumar Raiger
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Diastolic Blood Pressure ◽  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Motor Block ◽  
Control Group ◽  
Sensory Blockade ◽  
Group D

Background: Present study was designed to evaluate the effect of intravenous dexmedetomidine on haemodynamics, sedation and quality of spinal anaesthesia with 0.5% hyperbaric bupivacaine.Methods: Sixty ASA grade 1 and 2, 18-60 years aged patients scheduled for elective lower limb surgeries were randomly divided into two groups: Group C (Control) and Group D (Study), received intravenous normal saline 10ml and intravenous dexmedetomidine 1μg/kg in dilution of 10ml respectively over 10minutes duration, 10minutes before subarachnoid block with 2.5ml of 0.5% hyperbaric bupivacaine. The heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), quality of sensory and motor block and level of sedation were monitored intraoperatively and postoperatively.Results: The heart rate was statistically significantly decreased in group D both intraoperatively and postoperatively. Intraoperative and postoperative SBP and DBP were lower in dexmedetomidine group but clinically that was insignificant. Intraoperative Ramsay sedation scores were significantly higher in dexmedetomidine group (3.49±0.240) as compared to control group (2.51±0.249) (p<0.001) but the patients were easily arousable. The duration of sensory blockade (208.83±9.53 min vs 162.83±9.62 min), duration for 2 dermatomal regression of sensory blockade (146.5±10.013min vs 98±8.57min) and the duration for motor block regression to Modified Bromage scale 0 (167.33±10.5min vs 137.83±11.94min) were significantly prolonged in dexmedetomidine group as compared to control group. The highest level of sensory blockade was also significantly higher in dexmedetomidine group (T6.90±0.759 vs T7.60±0.621). There was no difference in the time for attaining highest level of sensory blockade, time taken for motor blockade to reach Modified Bromage Scale 3 between both the groups. Average 24hr mean VAS score was significantly lower in dexmedetomidine group (1.37±0.15 vs1.72±0.17, p<0.001). Time to first request for rescue analgesic was also significantly longer in dexmedetomidine group (mean 174.33min vs 143.5min). Average 24hour consumption of tramadol analgesic was significantly higher in control group as compared to dexmedetomidine group (391.86±111.62mg vs 279.86±80.55mg, p<0.001).Conclusions: Intravenous dexmedetomidine significantly prolongs the duration of sensory and motor block of bupivacaine spinal anaesthesia. It provides excellent sedation and analgesia. Dexmedetomidine induced decrease in heart rate, systolic/diastolic blood pressure are not clinically significant. 

scholarly journals Spinal Anaesthesia with Hyperbaric Prilocaine in Day-Case Perianal Surgery: Randomised Controlled Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Ozden Gorgoz Kaban ◽  
Dilek Yazicioglu ◽  
Taylan Akkaya ◽  
M. Murat Sayin ◽  
Duray Seker ◽  
...  
Keyword(s):  
Spinal Anaesthesia ◽  
Controlled Trial ◽  
Sensory Block ◽  
Local Anaesthetics ◽  
Day Case ◽  
Hyperbaric Bupivacaine ◽  
Versus Group ◽  
Group B ◽  
Randomised Controlled ◽  
Fentanyl Group

Background. The local anaesthetics used in day-case spinal anaesthesia should provide short recovery times. We aimed to compare hyperbaric prilocaine and bupivacaine in terms of sensory block resolution and time to home readiness in day-case spinal anaesthesia.Methods. Fifty patients undergoing perianal surgery were randomized into two groups. The bupivacaine-fentanyl group (Group B) received 7.5 mg, 0.5% hyperbaric bupivacaine + 20 μg fentanyl in total 1.9 mL. The prilocaine-fentanyl group (Group P) received 30 mg, 0.5% hyperbaric prilocaine + 20 μg fentanyl in the same volume.Results. Time to L1 block and maximum block was shorter in Group P than in Group B (Group P4.6±1.3 min versus Group B5.9±01.9 min,P=0.017, and Group P13.2±7.5 min versus Group B15.3±6.6 min,P=0.04). The time to L1 regression and S3 regression of the sensorial block was significantly shorter in Group P than in Group B (45.7±21.9 min versus59.7±20.9 min,P=0.024, and133.8±41.4 min versus200.4±64.8 min,P<0.001). The mean time to home readiness was shorter for Group P than for Group B (155±100.2 min versus207.2±62.7 min(P<0.001)).Conclusion. Day-case spinal anaesthesia with hyperbaric prilocaine + fentanyl is superior to hyperbaric bupivacaine in terms of earlier sensory block resolution and home readiness and the surgical conditions are comparable for perianal surgery.

scholarly journals Comparison of dexmedetomidine and buprenorphine as an adjuvant to bupivacaine during spinal anaesthesia for tibial interlocking nailing surgeries

2017 ◽  
Vol 4 (6) ◽  
pp. 1653
Author(s):  
Amitha S. ◽  
Pradeep R.
Keyword(s):  
Spinal Anesthesia ◽  
Spinal Anaesthesia ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Chi Square ◽  
Double Blind ◽  
Sensory Blockade ◽  
Exact Test ◽  
Interlocking Nailing ◽  
Group 3

Background: Buprenorphine is being used as an adjuvant to local anaesthetic for spinal anaesthesia since long. Dexmedetomidine is a new drug which has got alpha 2 agonistic property, and is being tried for spinal anesthesia along with bupivacaine in recent times. Settings and Design: This study was conducted in a prospective, randomized, controlled and double-blind manner. The study included ninety American Society of Anaesthesiologists class I and II patients undergoing tibial interlocking nailing surgeries under spinal anaesthesia.Methods: The patients were randomly divided into three groups (n=30 each) by closed envelope technique. Patients in group 1 received 15 mg of 0.5% hyperbaric bupivacaine, group 2 received 15 mg of 0.5% hyperbaric bupivacaine with 30μg of buprenorphine, and group 3 received 15 mg of 0.5% hyperbaric bupivacaine with 5μg dexmedetomidine for spinal anesthesia. The duration of motor and sensory blockade and any adverse events were recorded. Data were analysed using Chi-square test or Fisher’s exact test for categorical data and analysis of variance for continuous data. A value of P<0.05 was considered as statistically significant.Results: In our study the subjects in group 3 (dexmedetomidine) group had significantly longer period of motor blockade (240±20min) and sensory blockade (180±22.2min) compared to other groups, which is statistically significant (P=0.0001 and P= 0.006 respectively). The time to first request of analgesic in the post-operative period was also longer (240±30.2min) in dexmedetomidine group when compared with other groups (P=0.0001). There were no untoward complications (hypotension, sedation) in any groups.Conclusions: We concluded that dexmedetomidine (5μg) with bupivacaine for spinal anesthesia gives significantly longer duration of sensory and motor blockade, than buprenorphine (30μg) with bupivacaine for spinal anaesthesia.

scholarly journals Isobaric levobupivacaine a better and safer substitute for spinal anaesthesia in patients undergoing prolonged lower abdominal and lower limb surgeries

2018 ◽  
Vol 6 (9) ◽  
pp. 3111
Author(s):  
Wasimul Hoda ◽  
Abhishek Kumar ◽  
Priodarshi Roychoudhury
Keyword(s):  
Spinal Anesthesia ◽  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Motor Block ◽  
Sensory Block ◽  
Double Blind Study ◽  
Double Blind ◽  
Sensory Blockade ◽  
Group A ◽  
Group B

Background: Bupivacaine being the drug of choice for spinal anaesthesia is associated with serious cardiac toxicity. Levobupivacaine and ropivacaine, both being the two S enantiomers of bupivacaine can be a safer alternatives with better cardiovascular safety. Hence, the clinical efficacy of both were assessed and compared in patients undergoing spinal anesthesia.Methods: A prospective randomized controlled double blind study was done in 68 adult posted for elective lower abdominal and lower limb surgeries under spinal anesthesia. They were randomized into 2 groups. About 3ml isobaric levobupivacaine 0.5% (15mg) was given in group A and 3ml isobaric ropivacaine 0.5% (15mg) was given in group B. Onset, duration of sensory and motor blocks, time for maximum sensory and motor block, time for 2 segment sensory regression and haemodynamic parameters were recorded and analyzed.Results: All patients achieved a sensory block of T10 dermatome. Onset of sensory blockade at T10 was similar in both groups, group A (5.71±1.31min) and group B (5.94±1.72min). Time from injection to two dermatomal regression was 129.68±15.54min in group A and 111.38±22.35min in group B. Onset of Bromage score of 1 in group A was 4.68±1.27min and in group B was 6.44±1.64min. The mean duration of motor and complete motor block was prolonged in group A patients (197.74±18.51min, 168.82±17.90 min) as compared to group B (131.88±20.41min, 106.71±10.85min).Conclusions: Isobaric levobupivacaine was found to be a better and safer substitute for spinal anesthesia in patients undergoing prolonged lower abdominal and lower limb surgeries.

scholarly journals Comparison between high dose hyperbaric Bupivacaine (12.5 mg) alone versus low dose hyperbaric Bupivacaine (7.5 mg) with Fentanyl (25 µg) in spinal anaesthesia for inguinal hernia surgery

2016 ◽  
Vol 3 (3) ◽  
pp. 140 ◽  
Author(s):  
Manish B. Kotwani ◽  
Kanchan Rupwate ◽  
Prashanth Shivananda ◽  
Jyoti Magar
Keyword(s):  
Inguinal Hernia ◽  
Side Effects ◽  
Spinal Anesthesia ◽  
Low Dose ◽  
Opioid Analgesic ◽  
High Dose ◽  
Motor Blockade ◽  
Hyperbaric Bupivacaine ◽  
Inguinal Hernia Surgery ◽  
Group B

<p class="abstract"><strong>Background:</strong> For performing inguinal hernia surgeries, giving spinal anesthesia is a well known technique as it easy and provides fast onset, effective sensory and motor blockade in an awake patient. Now-a-days Bupivacaine is gaining importance as an effective spinal anaesthetic agent in combination with opioid analgesic Fentanyl to reduce the postoperative pain and side effects associated with surgery. This study aims to compare the effectiveness of intrathecal Bupivacaine alone versus combination of Bupivacaine with Fentanyl.</p><p class="abstract"><strong>Methods:</strong> The study designed was a prospective, randomized, double blinded comparative study. Patients were randomly divided into two groups of 25 each. Group B received hyperbaric intrathecal Bupivacaine 12.5 mg and Group BF received diluted hyperbaric intrathecal Bupivacaine 7.5 mg and Fentanyl 25 µg for spinal anesthesia . Parameters like sensory and motor block were assessed. Side effects produced during perioperative and postoperative period were observed and noted. Satisfactory criteria by the surgeons and patients were considered.</p><p class="abstract"><strong>Results:</strong> The time taken to attain surgical anesthesia and peak sensory levels in minutes was statistically significant in Group B compared to Group BF. Due to higher dose of Bupivacaine, it was observed that degree of motor blockade is also higher in group B when compared to group BF. The incidence of hypotension, nausea, vomiting and hypothermia are significantly higher in group B due to high dose of Bupivacaine. The surgeons and patients satisfaction was good in both the groups.  </p><p><strong>Conclusions:</strong> Low dose Bupivacaine in combination with Fentanyl is safe and effective alternative for spinal anesthesia for inguinal herniorrphaphy as compared to conventional high dose Bupivacaine alone.</p>

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