IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 19, Issue 12 Ser.6 (December. 2020), PP 14-18 www.iosrjournals.org DOI: 10.9790/0853-1912061418 www.iosrjournal.org 14 | Page To Compare Effects Of Buprenorphine And Dexmedetomidine As Adjuvant To Bupivacaine Spinal Anaesthesia In Elderly Patients Undergoing Lower Abdominal Surgeries: A Randomized Controlled Study. Dr.Animireddy Sai Srujan 1 , Dr.B.Sowbhagya Lakshmi 2 ,Dr.M.Santhi sree 3 , Dr.P. Krishna Prasad 4 1 st Author- Postgraduate, Department of anaesthesia, Rangaraya Medical College, Kakinada, 2 nd Corresponding Author- HOD and Professor, Department of Anaesthesia, RMC, Kakinada 3 rd Author - Associate Professor, Department of Anaesthesia, RMC, Kakinada 4 th Author- Associate Professor, Department of Anaesthesia, RMC, Kakinada . Abtract:Background and Aims: The objective is to compare the efficacy of addition of buprenorphine or dexmedetomidine to bupivacaine in sensory and motor blockade duration, two segment regression and time of first analgesic requirement. Use of low-dose spinal anaesthesia is advantageous in elderly as it reduces the hemodynamic and heart rate variability. Methods: sixty patients are randomly allocated into three groups Group A: received 15 mg of 0.5% hyperbaric bupivacaine along with 0.2 ml Normal saline; Group B: received 15 mg of 0.5% hyperbaric bupivacaine along with 60 mcg of buprenorphine; Group C: received 15 mg of 0.5% hyperbaric bupivacaine along with 5 mcg of dexmedetomidine. Data between the 3 groups were compared and analysed using ANOVA test and chi square test. Results: All 60patients completed the study. Postoperative analgesia was not required in the first 24 h in a total of 8 (40%), 12 (60%) and 15 (75%) patients in groups A, B, and D, respectively. Time to S1 regression was 129+/-44 min (Group A), 146+/-53.6 min (Group B) and 172+/-58.7 min (Group C), P = 0.0417 .Time to complete motor recovery was 177+/-56.9 min (Group A), 226+/-60 min (Group B) and 239+/-61.71min (Group C), P < 0.004. Conclusion: Addition of buprenorphine (60 μg) or dexmedetomidine (5 μg) to intrathecal bupivacaine for lower abdominal surgery prolongs the time to the first analgesic request Keywords: Anaesthesia, buprenorphine, dexmedetomidine, intrathecal. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 29-11-2020 Date of Acceptance: 14-12-2020 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Spinal anaesthesia is commonly used regional anaesthesia technique for lower limb and lower abdominal surgeries for its advantages like quick onset, excellent sensory & motor block, very economical and easy to administer 1 . Postoperative pain control by spinal anaesthesia with local anaesthetic alone causes relatively short duration of action, thus early analgesic intervention is needed in post operative period. Common problem during lower abdominal surgeries under spinal anaesthesia is visceral pain, nausea and vomiting. Use of higher doses of local anesthetics to avoid this may result in circulatory disturbances that can be difficult to manage as these patients are usually elderly and hence may have varying degrees of organ damage or associated systemic illness. A combination of low-dose local anesthetics along with other adjuvants can prolong the postoperative analgesia. Hence, this has become an attractive option. Several adjuvants such as opioids and Alpha 2 agonists have been studied in combination with intrathecal local anesthetics to improve the postoperative analgesia without compromising patient safety 1,2 . Dexmedetomidine is an alpha 2 adrenoreceptor agonist. It produces sedative and anxiolytic effects by its action on locus ceruleus of the brain stem. It also acts on dorsal horn neurons of spinal cord reducing the sympathetic discharge and also causes hyper polarization of dorsal horn cells. Buprenorphine is a opioid and it acts by stimulating kappa and mu opioid receptors and partially inhibiting delta opioid receptors. It has both spinal and supra spinal component of analgesia. The objective of this study is to compare the efficacy of addition of buprenorphine or dexmedetomidine to bupivacaine in sensory and motor blockade duration, two segment regression and time of first analgesic requirement