scholarly journals A comparison of epidural analgesia provided by Bupivacaine plus Pethidine, Bupivacaine plus Morphine, or Bupivacaine plus Morphine plus Midazolam for lower limb orthopaedic surgery

2014 ◽  
Vol 2 (3) ◽  
pp. 117-121
Author(s):  
Nil Raj Sharma ◽  
Pradip Timalsena ◽  
Sundip DC
Keyword(s):  
Epidural Anaesthesia ◽  
Lower Limb ◽  
Orthopaedic Surgery ◽  
Epidural Morphine ◽  
P Value ◽  
Medical College ◽  
Group A ◽  
The Difference ◽  
Group B

Background: Epidural anaesthesia and analgesia in orthopaedic surgeries helps to prevent thromboembolic phenomenon by increasing venodynamics. Adequate post-operative analgesia with good patient satisfaction has been observed with this technique. Objective: To assess the duration of postoperative analgesia and complications in patients receiving epidural anaesthesia with Morphine, Midazolam and Pethidine in combination with Bupivacaine. Methods: We prospectively studied 75 patients who were scheduled for elective lower limb orthopaedic surgery with epidural anaesthesia at Lumbini Medical College, Palpa from 2010 March to 2012 March. They were randomly divided by lottery method into three equal groups. Group ‘A’ (BP) received 50 mg epidural Pethidine (3 ml) with 13 ml of 0.5% Bupivacaine. Group ‘B’ (BM) received 5 mg (3 ml) epidural Morphine with 13 ml of 0.5% Bupivacaine and Group ‘C’ (BMM) received 5 mg (1 ml) epidural Morphine with 13 ml 0.5% Bupivacaine and 2 mg (2 ml) epidural Midazolam. All the patients were observed for 24 hours for quality of analgesia and other side effects like nausea, vomiting and pruritus. Data were analysed by Statistical Package for Social Sciences (SPSS-16) software. Results: The result of the study shows the duration of analgesia was prolonged in BM group than BP group and even more so in BMM group (p value <0.001). Incidence of nausea and vomiting in BMM group was lower than in BP and BM group but statistically the difference was not significant (p value: 0.489). Pruritus was absent in BP group, less in BMM group while significantly higher in BM group. Conclusion: The use of epidural Morphine and Midazolam in combination with Bupivacaine is the satisfactory method of post operative analgesia. When Midazolam is added, duration of analgesia can be increased with decrease in incidence of nausea, vomiting and pruritus.Journal of Kathmandu Medical College Vol. 2, No. 3, Issue 5, Jul.-Sep., 2013 Page: 117-121DOI: http://dx.doi.org/10.3126/jkmc.v2i3.9961Uploaded date : 3/4/2014

scholarly journals A comparison of epidural analgesia provided by Bupivacaine plus Pethidine, Bupivacaine plus Morphine, or Bupivacaine plus Morphine plus Midazolam for lower limb Orthopaedic surgery

2014 ◽  
Vol 4 (1) ◽  
pp. 19-21
Author(s):  
NR Sharma ◽  
U Rai ◽  
S Panthee ◽  
P Shrestha
Keyword(s):  
Epidural Anaesthesia ◽  
Lower Limb ◽  
Orthopaedic Surgery ◽  
Epidural Morphine ◽  
P Value ◽  
Medical College ◽  
Group A ◽  
Group B ◽  
Good Patient Satisfaction

Epidural anaesthesia and analgesia in orthopaedic surgeries helps to prevent thromboembolic phenomenon by increasing venodynamics. Adequate post operative analgesia with good patient satisfaction has been observed with this technique. The objective of this study was to assess the duration of postoperative analgesia and complications in patients receiving epidural anesthesia with morphine, midazolam and pethidine in combination with bupivacaine. We prospectively studied 75 Patients who were scheduled for elective lower limb orthopaedic surgery with epidural anaesthesia. This study was conducted from March 2010 to March 2012 at Lumbini Medical College Palpa. They were randomly divided by lottery method into three equal groups. Group ‘A’ (BP) received 50 mg epidural pethidine (3 ml) with 0.5 % bupivacaine 13 ml. Group ‘ B’ (BM) received 5 mg (3 ml) epidural morphine with 13 ml of 0.5% bupivacaine and Group’ C’ (BMM) received 5 mg (1 ml) epidural morphine with 13 ml 0.5% bupivacaine and 2 mg (2 ml) epidural midazolam. All the patients were observed for 24 hours for quality of analgesia and other side effects like nausea vomiting, and pruritus. Data were analysed by SPSS-16.0 software. The result of the study shows the duration of analgesia was prolonged in BMM group than BM, and BP group and was statistically significant (P value <0.001). Incidence of nausea and vomiting in BMM group was lower than that of BP and BM group but was statistically insignificantly (P value 0.489). Pruritus was absent in BP group and was more with BM and BMM group (P value 0.007). In conclusion the use of epidural morphine and midazolam in combination with bupivacaine is the satisfactory method of post operative analgesia. By adding midazolam, duration of analgesia can be increased with decrease in incidence of nausea, vomiting and pruritus. DOI: http://dx.doi.org/10.3126/jcmc.v4i1.10842 Journal of Chitwan Medical College 2014; 4(1): 19-21

scholarly journals COMPARATIVE STUDY OF HAEMODYNAMIC CHANGES BETWEEN 6% HYDROXYETHYLSTARCH 130/0.4 AND RINGER LACTATE COLOADING IN ELDERLY PATIENTS UNDERGOING LOWER LIMB ORTHOPAEDIC SURGERY UNDER SPINAL ANAESTHESIA

2019 ◽  
Vol 3 (6) ◽  
Author(s):  
Jayanta Chakraborty ◽  
Uma Mandal
Keyword(s):  
Elderly Patients ◽  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Orthopaedic Surgery ◽  
P Value ◽  
Ringer Lactate ◽  
Lower Limb Surgery ◽  
Group A ◽  
Group B ◽  
Lactate Solution

Background: Anaesthesia for the lower limb surgeries could be either general or regional. Studies had shown that regional anaesthesia for lower limb surgery results in better postoperative outcomes, including improved respiratory function, less nausea vomiting, less pain and lower incidence of deep vein thrombosis. Among all the regional anaesthetic techniques spinal anesthesia remained most preferred technique for its fast, predictable, profound, high quality sensory and motor block. However some complications like hypotension, bradycardia, post dural puncture headache, urinary retention were unavoidable and hypotension remained the most common one and found to be more in the elderly population with incidence of 25–82%. Treating spinal anaesthesia-induced hypotension included intravenous (IV) volume administration. IV Fluid infused before and at the time of spinal anaesthesia was referred to as preloading and coloading respectively. Although merit of coloading and the choice of fluid to be infused had remained  a matter of debate, till today no definitive study had indicated any superiority of colloids over crystalloids decisively  moreover large amount crystalloids to counter hypotensin  remained a threat to the cardiovascular overload for  elderly patients. Role of vasopressors in elderly remained controversial too. So this observational prospective study was  undertaken to compare  the effiicacy of coloading of infusion 6%HES 130/0.4 (colloid) and Ringer Lactate solution (crystalloid)  to maintain the intra operative haemodynamics in elderly patients undergoing lower limb orthopaedic surgery under spinal anaesthesia. Objectives: To assess and to compare the efficacy of infusion 6%HES 130/0.4 and infusion Ringer lactate solution coloading in preventing the intra-operative hypotension. Materials and method: On  approval of the Ethics Committee of Burdwan Medical College (BMC&H), 80 patients were included and equally divided into two groups group A and group B where groupp A received 6% HES  as coloading fluid and groupp B received RL as coloading fluid at the start of spinal anaesthesia. On entering Operation Theatre baseline parameters were noted for each patient and lumbar puncture for spinal anaesthesia was performed following strict aseptic precautions, in sitting position. Upon achieving adequate block episodes of hypotension were noted and treated according to the study protocol. Results: Statistical analysis for Continuous and categorical variables were done using Mann-Whitney U test and Pearson’s Chi Square test accordingly and p values less than 0.05 were considered significant. In group A, 17.5 % patients developed one episodes of hypotension whereas in group B, 37.5% patients developed one episodes of hypotension which was statistically significant with p value 0.0465.  In group A none of the patients developed further episodes of hypotension but in group B 5% affected patients developed one more episodes of hypotension and 2.5% affected patients developed two more episodes of hypotension. Average intravenous dose of mephentermine required to treat hypotension was 1.05 mg for group A and 2.70 mg for group B and found to be statistically significant with p value 0.039. Total fluid consumption In group A was 654.95 ml whereas in group B  was 976.73 ml and also  found to be statistically significant with p value <0.001. Conclusion:  The study found that coloading with 6% HES was significantly effective than Ringer Lactate solution in preventing episodes of hypotension in spinal anaesthesia induced elderly patients undergoing lower limb surgery without any noticeable adverse effect. Key Words: Spinal anaesthesia, lower limb surgery, elderly patients, coloading

scholarly journals A comparative study of the incidence of pain and infection in gall bladder extraction via umbilical and epigastric port

2017 ◽  
Vol 4 (2) ◽  
pp. 747 ◽  
Author(s):  
Jugendra Pal Singh Shakya ◽  
Neelabh Agrawal ◽  
Arun Kumar ◽  
Akash Singh ◽  
Bhupesh Gogia ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Randomized Study ◽  
Port Site ◽  
P Value ◽  
Medical College ◽  
Post Operative Pain ◽  
Group A ◽  
The Difference ◽  
Group B

Background: In laparoscopic cholecystectomy, gall bladder extraction via different ports has always been a matter of concern for the surgeons. This study is designed so as to determine the difference in the rate of pain and infection in gall bladder extraction via umbilical and epigastric port.Methods: A prospective randomized study was done from January 2015 to December 2015 at S. N. Medical College, Agra in which 200 patients of cholelithiasis were considered. The patients were randomly selected in the operation theatre for gall bladder extraction via epigastric port (designated as Group-A with n = 100 patients) and gall bladder extraction via umbilical port (designated as Group-B with n = 100 patients).Results: Post-operative pain at 24 hours, in terms of VAS was 3.67±1.42 in Group-A while 2.47±1.17 in Group-B with 10 being the worst pain. The p-value was calculated as .000048. The result is significant at p< .05. A total of eight patients out of two hundred patients suffered port site infections amongst which five were from Group-A (5%) and three were from Group-B (3%).Conclusions: This study thus indicates that in laparoscopic cholecystectomy, gall bladder retrieval through the umbilical port is a better alternative to gall bladder extraction via epigastric port in terms of post-operative pain and port site infection. Our study recommends gall bladder extraction via umbilical port rather than epigastric port. 

scholarly journals Monopolar Diathermy Tonsillectomy Versus Dissection Method Tonsillectomy

KYAMC Journal ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 21-24
Author(s):  
Md Abdus Salam ◽  
Md Mahbub Alam ◽  
Rezwan Ahmed ◽  
Md Sultan Mahmud
Keyword(s):  
Postoperative Pain ◽  
Postoperative Bleeding ◽  
Throat Pain ◽  
Medical College ◽  
Advantages And Disadvantages ◽  
Case Surgery ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Dissection Method

Background: Tonsillectomy is one of the most common surgical procedures performed worldwide by otorhinolaryngologists for different indications. Tonsillectomy is often performed as day-case surgery, which increases the demands of a satisfactory postoperative pain control and a low risk of early postoperative bleeding. Objective: The aim of the study was to compare the Monopolar diathermy and Dissection methods of tonsillectomy and evaluate their advantages and disadvantages during surgery, convalescence. Materials and Methods: Two hundred children were recruited for this study during the period of five years from January, 2014 to December, 2018 at Otolaryngology department of Khwaja Yunus Ali Medical College and Hospital (KYAMCH). Subjects between the age of 5 and 25 years listed for tonsillectomy were included. Subjects were recommended not to have aspirin within the 2 weeks before surgery. Results: The mean duration of operation was found 10.6±0.4 minutes in group A and 17.0±0.7 minutes in group B. The difference was statistically significant (p<0.05) between two groups. At 1st day, 11(11.0%) patients had throat pain in group A and 23(23.0%) in group B. At 2nd day, 14(14.0%) patients had throat pain in group A and 25(25.0%) in group B. Which were statistically significant (p<0.05) between two groups. Conclusion: The monopolar diathermy tonsillectomy appears to cause less bleeding, postoperative pain and less time consuming in compare with the dissection tonsillectomy although patients experience slightly more pain than dissection Method. KYAMC Journal Vol. 10, No.-1, April 2019, Page 21-24

Association of Adverse Outcomes in Patients with Cirrhosis Presented with COVID-19

2021 ◽  
Vol 15 (5) ◽  
pp. 1134-1135
Author(s):  
M. A. Chhutto ◽  
A. H. Mugheri ◽  
A. H. Phulpoto ◽  
I. A. Ansari ◽  
A. Shaikh ◽  
...  
Keyword(s):  
Liver Disease ◽  
Chronic Liver Disease ◽  
Adverse Outcomes ◽  
Chronic Liver ◽  
P Value ◽  
College Hospital ◽  
Medical College ◽  
Group A ◽  
Group B ◽  
Disease Study

Objective: To determine the association of adverse outcomes in term of mortality in patients with cirrhosis presented with coronavirus disease. Study Design: Retrospective/observational study Place and Duration of Study: Department of Medicine, Chandka Medical College Hospital, Larkana from 1st March 2019 to 31st December 2020. Methodology: Two hundred and twenty covid-19 patients of both genders with or without chronic liver disease were enrolled in this study. Patients were categorized in to two groups. Group A (with cirrhosis 60 patients) and group B (without cirrhosis 60 patients). Outcomes in term of mortality between both groups were examined. Results: There were 38 (63.33%) males and 22 (36.67%) were females with mean age 46.14±8.44 years in group A while in group B, 40 (66.67%) and 20 (33.33%) patients were males and females with mean age 45.26±9.34 years. Patients with cirrhosis had high mortality rate as compared to patients without cirrhosis (33.33% Vs 13.33%) with p-value 0.0001. Conclusion: A significant association of adverse outcomes was found in cirrhotic patients with coronavirus disease. Keywords: Chronic Liver Disease, Corvid-19, Mortality

scholarly journals Morphological Changes of Placenta in Preeclampsia

1970 ◽  
Vol 7 (1) ◽  
pp. 49-54 ◽  
Author(s):  
Segupta Kishwara ◽  
Shamim Ara ◽  
Khandaker Abu Rayhan ◽  
Mahamuda Begum
Keyword(s):  
Morphological Changes ◽  
Medical College ◽  
Group A ◽  
Different Shapes ◽  
The Difference ◽  
To Come ◽  
Group B ◽  
Larger Sample ◽  
Normal Placenta ◽  
Human Placentae

Context: Preeclampsia is regarded as a risk factor in pregnancy and it leads to placental insufficiency. This, in turn causes both maternal and fetal morbidity and mortality. The present study intends to compare the morphological changes of placenta in preeclampsia with that of normal placenta. Study design: A descriptive type of study. Place and period of study: Department of Anatomy, Dhaka Medical College, Dhaka, from August 2005 to June 2006. Materials: 60 human placentae, 30 were from normal pregnant women as control and 30 from pregnancies complicated by preeclampsia were taken for this study. Method: Samples were grouped as Group A and Group B on the basis of presence or absence of preeclampsia. All samples were studied morphologically. Result: Different shapes of placenta were found with some having accessory lobes in both groups. There was significant reduction (p< 0.001) in diameter and volume of placenta in Group B. The thickness of placenta was reduced in Group B but the difference did not reach a significant level. The number of cotyledon was significantly reduced in Group B (p<0.05). Conclusion: In this study, it was found that the preeclamptic placentae underwent definite morphological changes. These changes seemed to be the result of insufficiency of placenta in preeclampsia. However, further histological and morphometric placental study in a larger sample has to be conducted to come up with a conclusive decision. Key Words: Placenta, Preeclampsia, Morphology.   doi: 10.3329/bja.v7i1.3026 Bangladesh Journal of Anatomy January 2009, Vol. 7 No. 1 pp. 49-54

scholarly journals Histological study of proportion of cortex and medulla of the ovary in Bangladeshi women

2016 ◽  
Vol 44 (1) ◽  
pp. 8-10
Author(s):  
Hosna Ara Perven ◽  
Abu Sadat Mohammad Nurunnabi ◽  
Dilruba Siddiqua ◽  
Fatema Johora ◽  
Halima Afroz ◽  
...  
Keyword(s):  
Histological Study ◽  
Age Groups ◽  
Age Group ◽  
Cross Sectional ◽  
Medical College ◽  
Group A ◽  
The Mean ◽  
The Difference ◽  
Group B ◽  
The Right

This cross sectional, descriptive study was done in the Department of Anatomy, Dhaka Medical College, Dhaka from January to December 2009, to determine the proportion of cortex and medulla of the ovary in di_erent age group of Bangladeshi women. This study was based on collection of 140 ovaries of 70 unclaimed female dead bodies from the morgue of Dhaka Medical College, Dhaka. The samples were divided into three age-groups including A (10-13 years), B (14-45 years) & C (46-52 years). Histological slides were prepared by using routine haematoxylin and eosin stain. Ten best prepared histological slides from each age group were examined to determine the thickness of the cortex and medulla & proportion of the thickness of the cortex and the medulla of the ovary were expressed in percentages. The mean proportion of the cortex and the medulla of the right ovary were found 80.83±0.58% and 19.17±0.58% in group A, 86.95±1.14% and 13.05±1.14% in group B, 70.53±1.53% and 29.47±1.53% in group C respectively. The mean proportion of the cortex and the medulla of the left ovary were found 80.63±0.58% and 19.37±0.58% in group A, 86.78±1.14% and 13.22±1.14% in group B, 70.41±1.50% and 29.59±1.50% in group C respectively. The difference in mean proportion of the cortex and the medulla was not signi_cant in between the ovaries. However, the difference in mean proportion of the cortex and the medulla of the ovary between group A & group B, group A & group C and group B & group C were statistically significant.Bangladesh Med J. 2015 Jan; 44 (1): 8-10

scholarly journals EFFECT OF PAIRED FORMATIVE ASSESSMENT ON STUDENTS’ LEARNING

2021 ◽  
Vol 71 (3) ◽  
pp. 976-79
Author(s):  
Qamar Zia ◽  
Nighat Arif ◽  
Tahira Sadiq
Keyword(s):  
Formative Assessment ◽  
Control Group ◽  
P Value ◽  
Medical College ◽  
Quasi Experimental ◽  
Group A ◽  
Group B ◽  
Methods Of Learning ◽  
And Control ◽  
Academic Scores

Objective: To determine the effect of paired formative assessment on students’ learning. Study Design: Quasi experimental study. Place and Duration of Study: Islamic International Medical College Rawalpindi, from Jan 2018 to Jun 2018. Methodology: A total of 160 students who attended otolaryngology module were included in the study. Randomized allocation was done by computerized software programme and students were divided into 2 groups i.e. experimental (group A) and control group (group B). Later on in group A, pairing of students was done by lottery method. Group A and B were dealt with paired and individual formative assessment respectively. Effectiveness of both methods of learning was calculated on the basis of academic scores obtained in tests consisting of 20 MCQs from predefined and taught syllabus. A p-value were obtained by applying independent sample t-test and considered statistically significant at 0.05. Results: Out of 160 participants, 94 (58.7%) were females and 66 (41.3%) were males. In individual testing phase mean scores of group A was 13.36 ± 2.22 and mean scores of group B was 13.24 ± 2.5 (p 0.861). In paired formative assessment phase, mean scores of group A was 16.70 ± 1.94 (CI 95% 2.16-4.55) and mean of scores of group B was 13.40 ± 2.23 (CI 95% 2.16-4.55) p=0.001. Conclusion: The effectiveness of paired formative assessment. This method provides students a conducive environment to achieve learning objectives.

scholarly journals Haematocrit Value in Preeclampsia

2016 ◽  
Vol 30 (2) ◽  
pp. 80-85 ◽  
Author(s):  
Sankar Kumar Basak ◽  
Kohinoor Begum ◽  
Maliha Rashid ◽  
Nahid Yasmin ◽  
Hasina Begum
Keyword(s):  
Pregnant Women ◽  
Strong Association ◽  
Cross Sectional Study ◽  
P Value ◽  
College Hospital ◽  
Cross Sectional ◽  
Medical College ◽  
Group A ◽  
The Mean ◽  
Group B

Objective(s): To assess the association between the haematocrit value and severity of preeclampsia.Materials & Methods: This cross sectional study was conducted in the department of Obstetrics & Gynaecology of Dhaka Medical College Hospital, Dhaka during the period of January 2012 to December 2013. Total of 100 patients were studied and they were divided into two groups – group-A and group-B. Fifty preeclamptic patients were included in the group-A and 50 normal pregnant women were included in the group-B.Results: Majority of preeclamptic women (68%) and normal pregnant women (76%) were in the age group of 20-30 years with the mean ages of group-A and group-B subjects were 26.50±5.71 and 26.26±4.91 years respectively. Eighty six percent of group-A and 70% of group-B women were of lower socioeconomic status. Majority of the study subjects (74% of group-A and 80% of group-B) were housewife. More than half (54%) of the preeclamptic women were primigravid and 60% of normal pregnant women were multigravid. Among the preeclamptic subjects 16 (32%) had mild hypertension (DBP<110mmHg) and 34 (68%) had severe hypertension (DBP ? 110 mmHg). Out of 50 preeclamptic subjects 45 (90%) had severe proteinuria (+++) and only 5 (10%) had moderate (++) proteinuria.The mean haematocrit value of preeclamptic patients was 34.881±3.03 and that of normal pregnant women was 31.94±1.2. It was statistically significant (P value 0.001). The mean haematocrit value of normal pregnant, mild and severe preeclamptic women were 31.94±1.2, 33.31±2.57 and 35.62±2.95 respectively. It was also statistically significant (P value 0.001).Conclusion: This study shows that haematocrit value of preeclamptic patients is significantly higher compared to that of the normal pregnant women (P<0.05). There is a strong association of increasead haematocrit and preeclampsia.Bangladesh J Obstet Gynaecol, 2015; Vol. 30(2) : 80-85

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

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