الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Lower limb orthopedic surgeries performed under spinal anesthesia have the advantage of having rapid onset, maintaining spontaneous breathing, relaxing the necessary muscles for surgery, and cost effectiveness. It also has the advantage of being free from the risks of intubation and pulmonary aspiration. Aim of the Work: This study was designed to compare between intrathecal versus intravenous dexmedetomidine when added to bupivacaine on spinal block characteristics in patients undergoing lower limb orthopedic surgery regarding, onset and duration of sensory and motor block, quality of intra-operative anesthesia, postoperative analgesia, level of sedation, and adverse effects on patient hemodynamics. Patients and Methods: Following approval of our departmental ethical committee and obtaining informed consent, sixty patients scheduled for lower limb orthopedic surgeries under spinal anesthesia were enrolled in this prospective randomized comparative study. Results: ********. Conclusion: Both intrathecal and intravenous dexmedetomidine were safe adjuvants to bupivacaine spinal anesthesia. Intrathecal dexmedetomidine is superior adjuvant to spinal bupivacaine when compared to intravenous dexmedetomidine. It provides more stable hemodynamics, greater augmentation to sensory and motor block, better quality of perioperative analgesia and lesser overall side effects. Intravenous dexmedetomidine provides higher level of sedation during the intra-operative period. Recommendations: Further studies on a larger scale of patients are required to confirm the results obtained by this work.