scholarly journals Lower limb landmine injuries

2004 ◽  
Vol 28 (1) ◽  
pp. 37-43 ◽  
Author(s):  
S. Necmioglu ◽  
M. Subasi ◽  
C. Kayikci ◽  
D. B. Young
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Tendon Repair ◽  
Preoperative Assessment ◽  
Traumatic Amputation ◽  
Wound Debridement ◽  
Group I ◽  
Minimal Osteosynthesis ◽  
Limb Injuries ◽  
Group Ii

The medical records of 186 patients seeking treatment for landmine injuries in the authors' region between 1993 and 2001 were evaluated. Of these patients 13 died of accompanying complications. Ten (10) patients with general body trauma and upper limb trauma were excluded from the study. Of 163 patients with lower-limb injuries included in the study, 21 with traumatic amputation underwent surgical amputation at different levels. Patients without traumatic amputation were divided into 2 groups. There were 41 patients (29%) in Group I who were treated by limb salvage procedures. Treatments used in Group I including wound debridement, tendon repair, skin approximation, minimal osteosynthesis, external fixation of long bones and secondary wound coverage. In Group II, there were 101 patients (71%) with primary amputation. Trans-tibial amputation was performed in 52 cases (51.4%), ankle disarticulation in 24 (23.7%), trans-femoral amputation in 9 (8.9%), partial foot amputation in 8 (7.9%), knee disarticulation in 7 (6.9%) and hip disarticulation in 1 case. In Group I, there was infection in 21 patients (51.2%), revision in 27 (65.8%), and amputation in 15 (36.5%). In Group II, there was infection in 28 patients (27.7%), revision in 17 (16.8%), and amputation at a higher level in 8 (7%). In crush injuries such as those resulting from landmines, soft tissue, vascular, and neurological assessment must be performed with utmost care. Even so, the desired success in interventions intended to save a limb is complicated by a high infection rate, soft tissue complications, and high revision amputation rates. Therefore, a decision to amputate in the early term based on an accurate preoperative assessment is crucial

scholarly journals A Study of Clinical Applications of Perforator-Based Propeller Flaps in Leg Reconstructive Surgery: A Single-Center Experience of 40 Cases

2019 ◽  
Vol 19 (1) ◽  
pp. 70-77 ◽  
Author(s):  
Shahab Faria Shahabuddin ◽  
Mohammed Fahud Khurram
Keyword(s):  
Soft Tissue ◽  
Lower Limb ◽  
Soft Tissue Defect ◽  
Surgical Reconstruction ◽  
Flap Necrosis ◽  
Aesthetic Result ◽  
Propeller Flap ◽  
Degloving Injury ◽  
Group I ◽  
Group Ii

Soft tissue management in lower limb poses a considerable challenge to a reconstructive plastic surgeon. Perforator-based propeller flaps can cover large wounds without sacrificing a major vascular axis and allows reconstruction using nearby similar tissues, thereby following the principle of replace like with like. This study was undertaken with the objective to look for the results of propeller flap in lower limb reconstruction and how the results can be improved. This was a retrospective study on 40 patients who underwent the reconstruction of soft tissue defects of lower limb with propeller flap. All the relevant data were collected and analyzed. Patients with soft tissue defect anywhere in the leg were included, but patients who had history of degloving injury, peripheral vascular disease, and diabetes mellitus were excluded. All these patients were divided in 2 groups according to the angle of rotation of propeller flap. Group I had 20 patients in which the flap was rotated by 150° to 180°. Group II had 20 patients, and the flap was rotated by 90° to 150°. Postoperatively, the first 2 cases in Group I showed total flap congestion and had complete necrosis, which were debrided and an alternate method was used to reconstruct. Thereafter, no patient had total flap necrosis. Minor complications were seen in 3 patients who showed transient venous congestion of the flap. Group II had no flap necrosis except for mild dehiscence, which was managed by secondary suturing. In most cases, the aesthetic result was acceptable and patients were completely satisfied. When parameters of the defect are suitable for treatment with a propeller-based local flap, this technique may be considered as the first option for surgical reconstruction. Proper planning, location of perforator with preoperative and intraoperative audio Doppler, and use of magnification would make this procedure more successful and definitely decrease the use of long-duration microvascular surgery.

scholarly journals Influence of the Neural Crest Derived Stem Cells to Optic Nerve Regeneration After Its Experimental Injury

2021 ◽  
Keyword(s):  
Stem Cells ◽  
Optic Nerve ◽  
Soft Tissue ◽  
Neural Crest ◽  
Orbital Trauma ◽  
Tissue Content ◽  
Group I ◽  
Group Ii ◽  
Experimental Injury ◽  
Orbital Soft Tissue

Purpose: Orbital trauma is a challenging problem due to such severe sequel as diplopia, decrease of vision or eye motility disorder. However, the conditions of orbital soft tissue content still become underestimated. The aim of this study was to investigate structural changes in the rat optic nerve after experimental injury followed by treatment with stem cells. Materials and Ьethods: An experimental model of injury to the orbital soft tissue content in the rat was developed. Forty Wistar rats maintained under daylight were divided into two equal experimental groups. Unlike the rats of Group I, in rats of Group II, the site of injury to the orbital soft tissue mass received postnatal multipotent stem cells, epidermal neural crest stem cells (NCSCs) derived from the bulge of hair follicles. Results: Comparing the number of glial cells per certain area of the slice (NC) between group І and site without injury (control) after 3 week of observation, it was higher in group I more than 258.8% (p < 0.0001) and on 272.4% in group II (p < 0.0001). After 6 weeks NC in group I was higher than at previous terms: more then 128.9% (р < 0.0001). At the same, NC in group II was higher comparing with previous terms only on 17.1% (р = 0.0212). Between the animals of group I at terms of 12 and 24 weeks NC high and wasn’t significantly differ between this terms of observation (ANOVA p = 0.4379). In contrast, NC in group II stopped rising between 6 and 12 weeks demonstrating statistical equality (p = 0.4563). Conclusions: It can be assumed that the application of mesenchymal stem cells, derivates of the neural crest, after the experimental orbital trauma, stimulates a recovery of the optic nerve. Further studies should be performed to more deeply discover the neural crest derived stem cell populations, ivoleved into recovery of damaged optic nerves.

scholarly journals Obstetrical Soft Tissue Trauma during Spontaneous Vaginal Birth in the Romanian Adolescent Population—Multicentric Comparative Study with Adult Population

2021 ◽  
Vol 18 (21) ◽  
pp. 11491
Author(s):  
Alexandra Matei ◽  
Elena Poenaru ◽  
Mihai Cornel Traian Dimitriu ◽  
Cristina Zaharia ◽  
Crîngu Antoniu Ionescu ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Vaginal Birth ◽  
Adult Women ◽  
Young Mothers ◽  
Soft Tissue Trauma ◽  
Chi Square ◽  
Perineal Lacerations ◽  
Group I ◽  
Group Ii ◽  
Tissue Trauma

Romania is a country with high rates of adolescent births, associating scarce comprehensive obstetrical management with this specific population. This research aims to assess soft tissue trauma after vaginal birth in teenage mothers compared to their adult counterparts. A retrospective case-control study was conducted for one year in two hospitals. All vaginal deliveries were considered; the age cut-off value was considered at 20 years old for case and control groups. Lacerations were divided into three subgroups, considering the involved anatomical region; group I: labial and periurethral lacerations, group II: vaginal and perineal lacerations, and group III: cervical lacerations. There were 1498 women included in the study: 298 young mothers and 1200 adults. Teenagers were more likely to have an episiotomy during vaginal delivery compared to adult women: 56% versus 26.7% (p = 0.00, Pearson Chi-square) and a 1.89 times increased risk for developing additional group II lacerations: p = 0.01, Pearson Chi-square test with Bonferroni correction: OR = 1.89, 95% CI: 1.18–3.02. Group II lacerations were the most frequent type of birth trauma in both study groups. Fetal weight ≥4000 g was associated with a two times higher risk for vaginal and perineal lacerations when age criterion was not considered (OR = 1.98, 95% CI: 1.13–3.47, p = 0.01). The incidence of group I and II lacerations increased with age: from 0% and 9.1% between 10 and 14 years old to 6% and 26.2% between 18 and 19 years old. All groups of lacerations were more often identified in the case group, compared to the adult group. Fetal macrosomia and spontaneously ruptured membranes at admission could not be documented as risk factors for obstetrical injury in young mothers. Episiotomy performed in teenagers was not a protective procedure for group II lacerations.

scholarly journals A comparative study of hemodynamic changes and adverse effects of intrathecal bupivacaine with fentanyl and intrathecal bupivacaine with clonidine in infra-umbilical abdominal and lower limb surgery

2019 ◽  
Vol 6 (11) ◽  
pp. 4048
Author(s):  
Krishna Prasad G. V. ◽  
Vipin Jaishree Sharma
Keyword(s):  
Adverse Effects ◽  
Lower Limb ◽  
Analgesic Effects ◽  
Anesthetic Agents ◽  
Group I ◽  
Significant Difference ◽  
Lower Limb Surgery ◽  
Hemodynamic Profile ◽  
Group Ii ◽  
Intrathecal Clonidine

Background: Adjuvants prolong the action of intrathecal local anesthetic agents. They have shown to have significant analgesic effects in the postoperative period much after the regression of the sensory and motor blockade. Our objective of the current study was to compared the hemodynamic profile and adverse effects (nausea, pruritus, sedation and respiratory depression) in two groups of adult patients undergoing infra-umbilical and lower limb surgery under spinal anaesthesia using either intrathecal clonidine or intrathecal fentanyl as an adjuvant to intrathecal bupivacaine (0.5% heavy).Methods: This randomized, prospective and observational study was undertaken in the Department of Anaesthesiology and Critical Care, 5 Airforce Hospital, Kanpur from the period of January 2014 to February 2016 on 120 patients fulfilling the inclusion criteria. Study patients were randomly allocated to the two groups Group I: Cases who received intrathecal 0.5% heavy bupivacaine (2.5 ml) + fentanyl (50 mcg/ml) (0.5 ml) (n=60 patients) and Group II: cases who received intrathecal 0.5% heavy bupivacaine (2.5 ml) + clonidine (60 mcg/ml) (0.5 ml) (n=60 patients).Results: Mean age of patients in Group I and Group II was 42.60±5.93 and 42.03±7.16 years, respectively. Mean BMI of patients in Group I and Group II was 22.0±1.92 and 21.54±2.14 kg/m2, respectively. Comparison of baseline hemodynamic parameters (heart rate (bpm), mean arterial pressure (mmhg), respiratory rate (/min) and oxygen saturation (%) did not show a significant difference between two groups.Conclusions: With respect to the side effects like nausea and pruritus, these are significantly more in fentanyl group as compared to clonidine group.

scholarly journals Limb Salvage in Early Versus Delayed Revascularization of Acute Lower Limb Ischemia

2021 ◽  
Vol 15 (9) ◽  
pp. 2239-2241
Author(s):  
Salman Jamil Noor ◽  
Nauman Imtiaz ◽  
Wishal Shaukat ◽  
Athar Abbas Gilani ◽  
Palwasha Shahid ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Lower Limb ◽  
Limb Ischemia ◽  
P Value ◽  
Limb Salvage Rate ◽  
Lower Limb Ischemia ◽  
Group I ◽  
Significant Difference ◽  
Group Ii ◽  
Salvage Rate

Aim: To compare the limb salvage rate in early versus late presenting patients of Rutherford class IIB acute lower extremity ischemia undergoing revascularization. Study Design: Comparative/observational study Place and duration of study: Department of Surgery, CMH Peshawar from January 2019 to March 2021 Methodology: Twenty eight patients of both genders with ages 20 to 70 years presented with Rutherford class IIB acute lower limb ischemia were enrolled in this study. Patients were divided into two groups. Group I (presented after 6 hours of onset of symptoms) consisted of 20 patients and group II (presented within 6 hours of onset of symptoms) consisted of 8 patients. All the patients underwent femoral embolectomy. Limb salvage rate between both groups was examined at postoperative 3rd month. Data was analyzed by SPSS 24.0. P-value <0.05 was taken as significant. Results: There were 16(80%) male and 4(20%) females with mean age 50.52±11.74 years in group I, in group II 6(75%) were male and 2(25%) were females with mean age 50.08±10.94 years. No significant difference was observed between both groups regarding age and gender with p-value >0.05. In group I, limb salvage found in 19(95%) patients while in group II limb salvage found in 5(62.5%) patients, a significant difference was observed regarding limb salvage rate between both groups (p-value <0.05). Mortality rate was high in group II (delayed presentation) as compared to group I (12.5% Vs 0%) with p-value <0.05. Conclusion: The limb salvage rate was high in early presenting patients than late presenting patients with a significant difference. 30 days mortality rate and amputation rate were significantly high in delayed presentation as compared to early presented cases. Keywords: Acute lower limb ischemia, revascularization, limb salvage

Comparison of AdvanSync2® and Twin Block Appliances in Treatment of Class II Malocclusion With Retrognathic Mandible—An Observational Retrospective Study

2021 ◽  
pp. 030157422110572
Author(s):  
Ankit Kumar Shahi ◽  
Payal Sharma ◽  
Achint Juneja ◽  
Divya Shetty ◽  
Rishibha Bhardwaj ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Class Ii ◽  
T Test ◽  
Growth Spurt ◽  
Class Ii Malocclusion ◽  
Twin Block ◽  
Group I ◽  
Tissue Changes ◽  
Group Ii ◽  
Soft Tissue Changes

Objectives: To evaluate the treatment outcomes between Twin Block and AdvanSync2® appliances by comparing the skeletal, dentoalveolar, and soft tissue changes. Materials and Methods: Radiographic data of 20 patients were retrospectively analyzed. Data were selected from patients in their skeletal growth spurt as evaluated by the cervical vertebral maturation method (CVMI 2, 3, and 4), with class II malocclusion characterized with retrognathic mandible (ANB > 4°, SNB < 77°, FMA = 25 ± 5°, overjet > 5 mm). There were 10 patients in each group that underwent orthodontic correction for class II malocclusion: either using Twin Block or AdvanSync2®. Independent t test and Paired t test and chi-square tests were used for the data analysis. The level of statistical significance was set at P value ≤.05. Results: The chronological and skeletal age were similar in both the groups. Records were taken for the functional treatment with mean treatment span of 8 ± 1 month. Changes in SNB (group I = 1.59°, group II = 3.11°) ( P < .01), Co-Gn (group I = 2.89 mm, group II = 5.34 mm), and U1-L1° (group I = −1.51°, group II = 2.97°) showed statistically different outcome between the groups, when the pre-post data were studied. Rest of the variables—cranial base, maxillary skeletal, mandibular skeletal, intermaxillary, vertical skeletal, maxillary dentoalveolar, mandibular dentoalveolar, and soft tissue—showed similar outcome ( P > .05). Conclusion: Both appliances lead to desirable outcomes in the correction of class II malocclusion. AdvanSync2® resulted in inducing more of changes in SNB and effective mandibular length as compared to Twin Block. Overjet and molar relation improved significantly with both the appliances. Both the appliances resulted in similar skeletal, dentoalveolar, and soft tissue changes.

Comparative study between paracetamol versus paracetamol and pregabalin combination for postoperative analgesia in hip surgeries

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A R M Hassab ◽  
H M Fawzy ◽  
S M Elfawal ◽  
D M Kamaleldin
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Demographic Data ◽  
Preoperative Assessment ◽  
Multimodal Analgesia ◽  
Blurred Vision ◽  
Arterial Blood ◽  
Group I ◽  
Group Ii

Abstract Introduction Pregabalin has been used for treatment of chronic pain, but recently it has been introduced in treatment of acute postoperative pain. Aim of Study This study is conducted to evaluate the postoperative analgesic effect of paracetamol and pregabalin combination versus paracetamol after hip surgeries. Methods The study was done on 20 randomly chosen patients after approval of the medical ethical committee of Ain Shams University. Patients were divided randomly into two groups, each group consisted of 10 patients.After preoperative assessment and obtaining baseline vital data all patients received spinal anaesthesia. Group I received paracetamol 1gm intravenous immediately postoperatively and every 6 hours for 24 hours. Group II received the same as group I plus two doses of oral pregabalin 300mg in the recovery room and 12 hours later. The two groups were assessed postoperatively and they were compared regarding demographic data, postoperative pain control, sedation, total pethidine consumption, hemodynamics and side effects. Results In pregabalin group (group II), pain scores and total pethidine consumption were significantly lower and sedation scores were higher than group II. Heart rate and arterial blood pressure were lower in group II but without clinical significance. Conclusions This study revealed that combination of paracetamol and pregabalin as multimodal analgesia is better than paracetamol alone in postoperative analgesia, and decreasing use of opioids without significant effect on hemodynamics but with increased incidence of side effects such as somnolence, dizziness and blurred vision.

Surgical Treatment of Moderate Hallux Valgus: A Comparison of Distal Chevron Metatarsal Osteotomy With and Without Lateral Soft-Tissue Release

2017 ◽  
Vol 10 (6) ◽  
pp. 524-530 ◽  
Author(s):  
Maki Grle ◽  
Goran Vrgoc ◽  
Ivan Bohacek ◽  
Vladimir Hohnjec ◽  
Marko Martinac ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Surgical Treatment ◽  
Soft Tissue ◽  
Hallux Valgus ◽  
Soft Tissue Release ◽  
Metatarsal Osteotomy ◽  
Group I ◽  
Group Ii ◽  
Surgical Treatments

Purpose: The purpose of the study was to determine whether lateral soft-tissue release (LSTR) has a beneficial or detrimental effect on the outcome of distal Chevron first metatarsal osteotomy (DCMO) in the treatment of moderate hallux valgus (HV). Methods: We compared the effect of different surgical treatments in 2 groups of patients: group I (23 patients, 25 feet, average age of 55 [from 43 to 77] years) was subjected to DCMO only, whereas group II (18 patients, 23 feet, average age of 59 [from 52 to 70] years]) was subjected to DCMO with LSTR. The American Orthopaedic Foot and Ankle Society’s Hallux Metatarsophalangeal-Interphalangeal scale survey was conducted postoperatively, followed by the brief survey on postoperative patient satisfaction. The patient follow-up period was from 18 to 24 months after surgical treatment, on average. Results: After surgical intervention, both groups of patients presented with an improved HV angle, but there was no significant difference between the groups. However, group II showed significant improvements in medial sesamoid bone position and patient satisfaction scores as compared with group I. Conclusion: Our midterm follow-up of surgical treatments for moderate HV deformity suggests that both procedures provide good postoperative results. However, according to our results, DCMO with LSTR provides better results than procedures without LSTR. Levels of Evidence: Therapeutic, Level III: Retrospective comparative study

scholarly journals AB1310-HPR EFFECTS OF INSTRUMENT-ASSISTED SOFT TISSUE MOBILIZATION ON FROZEN SHOULDER: A RANDOMIZED CONTROLLED TRIAL

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1945.2-1945
Author(s):  
E. Kaya Mutlu ◽  
T. Birinci ◽  
S. Kilic
Keyword(s):  
Soft Tissue ◽  
Range Of Motion ◽  
Frozen Shoulder ◽  
Controlled Study ◽  
Joint Mobilization ◽  
Randomized Controlled ◽  
Constant Murley Score ◽  
Group I ◽  
Group Ii ◽  
Soft Tissue Mobilization

Background:Frozen shoulder has a greater incidence, more severe course, and resistance to treatment in patients. Management is based on the underlying cause of pain and stiffness. Joint mobilization has been reported to improve joint range of motion in frozen shoulder. However, there is no information regarding the effect of instrument-assisted soft tissue mobilization (IASTM) in frozen shoulder. We proposed that there would be no significant difference between the two manual physical therapy techniques with relatively similar treatment effects in the frozen shoulder.Objectives:The aim of this randomized controlled study was to compare the effectiveness of IASTM and joint mobilization in the treatment of patients with frozen shoulder.Methods:Thirty patients with phase II frozen shoulder (mean age 50,9 years, age range 39–65 years) were randomly assigned to one of the two treatment groups: Group I received joint mobilization combined with manual stretching exercise and Group II received IASTM with manual stretching exercise (two days per week for six weeks) (Figure 1). The pain level was evaluated with a visual analogue scale (VAS) and the active range of motion (ROM) was measured with a universal goniometer. The Disabilities of the Arm, Shoulder and Hand score and the Constant-Murley score were used for functional assessment. The assessments were performed at baseline and after the 6-week intervention.Figure 1.Instrument-Assisted Soft Tissue MobilizationResults:Both groups had a significant decrease in pain according to VAS and a significant increase in ROM and function level (p<0.05). After the 6-week intervention, improvement of shoulder abduction ROM in Group I was found significantly higher than Group II (p=0.01), on the other hand, Constant-Murley score in Group II was found significantly higher compared to Group I (p=0,001).Conclusion:Our results supported the hypothesis that either joint mobilization or IASTM, performed in addition to stretching exercise, provided similar improvements in pain levels in patients with the frozen shoulder.References:[1]Kelley MJ, Shaffer MA, Kuhn JE, Michener LA, Seitz AL, Uhl TL, et al. Shoulder Pain and Mobility Deficits: Adhesive Capsulitis, J Orthop Sports Phys Ther, 2013:43:1-31.[2]Celik D, Kaya Mutlu E.Does AddingMobilization toStretchingImprove Outcomes for People with Frozen Shoulder? A Randomized Controlled Clinical Trial, Clin Rehab, 2016: 30(8): 786-794.[3]Iked N, Otsuka S, Kawanishi Y, Kawakami Y. Effects of Instrument-Assisted Soft Tissue Mobilization on Musculoskeletal Properties, Med Sci Sports Exerc, 2019:51(10): 2166-2172.Disclosure of Interests:None declared

scholarly journals COMPARATIVE STUDY OF INTRATHECAL FENTANYL WITH HYPERBARIC BUPIVACAINE TO IMPROVE PERIOPERATIVE ANALGESIA IN PATIENT UNDERGOING ORTHOPEDIC SURGERY

2021 ◽  
pp. 55-58
Author(s):  
Rahul Wagh ◽  
Swapnil Sangale ◽  
Nagesh Jambure
Keyword(s):  
Side Effects ◽  
Lower Limb ◽  
Motor Block ◽  
Control Group ◽  
Study Group ◽  
Hyperbaric Bupivacaine ◽  
Analgesic Requirement ◽  
Sensory Blockade ◽  
Group I ◽  
Group Ii

Background: Various methods exist for treating post-operative pain which includes systemic narcotics, NSAIDS, patient-controlled analgesia, regional anaesthesia techniques, epidural local anaesthetic – narcotic mixtures, cryoanalgesia, transcutaneous electric nerve stimulation, psychological methods. Various opioides intrathecally and epidurally have been tried for post-operative analgesia. These include - morphine, pethidine, pentazocine, methadone, tramadol, Fentanyl, sufentanyl. In present study, we tried to find out analgesic effectiveness of intrathecal Fentanyl for post-operative analgesia, combined with 0.5 % Bupivacaine and side effects if any, in patients undergoing lower limb surgeries. Materials and Methods: After approval from the local ethics committee and with written informed consent from patient, a randomized controlled prospective study is carried out in the medical college and hospital.100 patients belonging to American Society of Anesthesiologists (ASA)classification I &amp; II, aged between 18-60 years, posted for elective lower limb surgeries, were randomly allocated for the study. Group-I: 50 patients received intrathecal 3 ml of 0.5 % hyperbaric Bupivacaine only. Group-II : 50 patients received intrathecal 3 ml of 0.5% hyperbaric Bupivacaine and Fentanyl 25 mcg.The patients studied across the group did not vary much with respect to age,height, weight and sex distribution. Results: The onset of sensory blockade was faster by 1.27 min in Group-BF. The perioperative and postoperative hemodynamic parameters were comparable in both the groups. The sensory analgesia in Group II was significantly prolonged by 159 mins, thus increasing the duration of analgesia. The time of first request of analgesics by the patients in group-II is prolonged compared to group-I thus prolonging the duration of analgesia. Analgesic requirement is also reduced in study group in early post-operative period. The onset of motor block was faster when Fentanyl was added to intrathecal Bupivacaine and it was 1.1 min earlier in study group. The duration of motor block to Bromage III was prolonged by almost 22 min in study group as compare to control group. Visual analogue scores were significantly lower in group-II compared to group-I after two hours of surgery thus reducing the frequency of supplemental postoperative analgesics. Conclusion: With the present study we can summarize that intrathecal Fentanyl potentiates the action of Bupivacaine thereby bringing about better quality and longer duration of analgesia, intense motor block, no hemodynamic disturbance and better postoperative outcome with/ minimum side effects.

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